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Revista del Instituto de Medicina Tropical

versión impresa ISSN 1996-3696

Resumen

LOVERA, Dolores et al. Complications associated with severe thrombocytopenia in patients with dengue. Rev. Inst. Med. Trop. [online]. 2020, vol.15, n.2, pp.19-28. ISSN 1996-3696.  https://doi.org/10.18004/imt/2020.15.2.19.

Introduction.

Severe platelet disease is a recognized warning sign of dengue.

Objective.

To determine the relationship between platelet count and dengue severity in children.

Methodology.

Children younger than 15 years hospitalized with the diagnosis of dengue between 2007-2018 were evaluated for the platelet`s count and severity of the disease. The patients were divided into 2 groups, according to whether the count o platelets was greater or less than 100,000 / mm3.

Results.

Eight hundred eighty two hospitalized patients with dengue were included in the study, with a mean age of 9.7 ± 4.6 years, and the same sex distribution: (437 (49.5%) female and 445 (50.5%) male. Sixty-two % (550 pts) presented platelets ≤100,000 / mm3. There were no differences in the frequency of fever (99% vs. 98%), headache (54% vs. 62%), rash (38% vs. 34%) and myalgia (42% vs. 47%) among those patients with platelets <100,000 / mm3 vs > 100,000 / mm3. However, the frequency of bleeding (28% vs 26%, p <0.01; OR = 1.61, 95% CI 1.16-2.23), vomiting ( 64% vs 57%, p <0.001; OR = 2.35, 95% CI 1.78-3.11), abdominal pain (64% vs 58%, p <0.001; OR 2.16, 95% CI 1.64-2.85) shock (53% vs 41%; p <0.001; OR = 2.39, 95% CI 1.79-3.18), hepatitis (defined as an increase in transaminases> 3 times normal) (10% vs 2%; p <0.0001; OR = 7.41, 95% CI 2.93-18.70), the presence of extravasations (49% vs. 4%; p <0.0001; OR 27.7, 95% CI 14.86-51.57), and admission to ICU (11% vs. 0.4%, p <0.0001; OR 41.29, 95 % CI 5.69-299.33) it was higher in patients with platelets <100,000 / mm3.

Conclusions.

The present study shows that dengue severity is higher in dengue patients with platelets <100,000 / mm3 and those complications are influenced by it.

Palabras clave : Dengue; thrombocytopenia; children.

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