Correlation between hematological and serological parameters in dengue patients- an analysis of 2022 cases
Abstract
Background: Dengue is a mosquito borne viral disease in the world that has emerged as a major public health problem with its diverse clinical manifestations. Assessment of both the serological and hematological parameters are of importance for the diagnostic and prognostic utility.
Aims: To study the various serological and hematological parameters in dengue patients and correlation between them.
Materials and Methods: This was a prospective studyof 2022 seropositive dengue cases conducted in a Tertiary care hospital at Dehradun over a period of two years (September 2016-August 2018). Hematological analysis was done using SYSMEX XN1000 and various parameters (WBC, RBC and Platelet parameters) were evaluated. The subjects were divided into six serogroups (NS1 positive, NS1+IgM positive, IgM positive, IgG +NS1, IgM+IgG and triple positive) and correlation between different hematological and serological parameters was done using SPSS softwareand ANOVA test was used to calculate the p value.
Results: A total of 2022 seropositive cases were studied out of which majority (72.3%) were NS1 positive. Male predominance was noted. Maximum cases were in the 11-20 year age group. The most affected parameters were platelet count (thrombocytopenia in 62.6%) and plateletcrit (reduced in 65.6%). There was a significant correlation of Hemoglobin. Platelet count, Plateletcrit, TLC, Percentage of neutrophil. lymphocyte and eosinophil amongst serological groups (p value was significant i.e. <0.05 in both the sex). In addition, RBC count also showed a significant association (p<0.05) in males.
Conclusion: Peripheral blood parameters (esp RBC, Hb, Percentage of neutrophil. lymphocyte and eosinophil, platelet count and plateletcrit) along with serological markers are helpful in disease monitoring and predicting the disease course.
Downloads
References
2. Kurane I. Dengue hemorrhagic fever with special emphasis on immunopathogenesis. Comp Immunol Microbiol Infect Dis. 2007 Sep;30(5-6):329-340. doi: https://doi.org/10.1016/j.cimid.2007.05.010
3. Gubler DJ. Dengue and dengue hemorrhagic fever. Clin Microbiol Rev. 1998;11(3):480-496. doi: 10.1128/ CMR.11.3.480
4. Guzman MG, Halstead SB, Artsob H, Buchy P, Farrar J, Gubler DJ, et al. Dengue: a continuing global threat. Nat Rev Microbiol. 2010;8(12 Suppl):S7-S16. doi: 10.1038/nrmicro2460.
5. Bhatt S, Gething PW, Brady OJ, Messina JP, Farlow AW, Moyes CL, et al. The global distribution and burden of dengue. Nature. 2013;496(7446):504-507. doi: 10.1038/nature12060.
6. Young PR, Hilditch PA, Bletchly C, Halloran W. An antigen capture enzyme-linked immunosorbent assay reveals high levels of the dengue virus protein NS1 in the sera of infected patients. J Clin Microbiol. 2000; 38(3):1053-1057.
7. Alcon S, Talarmin A, Debruyne M, Falconar A, Deubel V, Flamand M. Enzyme-linked immunosorbent assay specific to Dengue virus type 1 nonstructural protein NS1 reveals circulation of the antigen in the blood during the acute phase of disease in patients experiencing primary or secondary infections. J Clin Microbiol. 2002;40 (2):376-81. doi:10.1128/jcm. 40.02. 376-381.2002
8. Shu PY, Huang JH. Current advances in dengue diagnosis. Clin Diagn Lab Immunol. 2004;11(4):642-650. doi:10.1128/CDLI.11.4.642-650.2004
9. Gubler DJ. Serological diagnosis of dengue haemorrhagic fever. Dengue Bull 1996;20:20-23.
10. Azin FR, Gonçalves RP, Pitombeira MH, Lima DM, Castelo Branco I. Dengue: profile of hematological and biochemical dynamics. Rev Bras Hematol Hemoter. 2012;34(1): 36-41. doi: 10.5581/ 1516 -8484.20120012.
11. Mehta RC, Goswami HM, Katara RK, Patel PS, Parikh UV, Vegad MM, Jain PY. Importance of complete blood count and peripheral smear examination in early diagnosis of dengue patients. J Infect Dis Let. 2013;2(1):22-24.
12. Kidwai AA, Jamal Q, Farooqi FR, Ullah S. Serodiagnosis of dengue infection using rapid immunochromatography test in patients with probable dengue infection. J Pak Med Assoc. 2010;60(11):936-939.
13. Halstead SB, Nimmannitya S, Cohen SN. Observations related to pathogenesis of dengue hemorrhagic fever. IV. Relation of disease severity to antibody response and virus recovered. Yale J Biol Med. 1970;42(5):311-328.
14. Kaur R, Babita, Sama P. Hematological and biochemical changes in dengue fever. Int J Pharma Sci Inv 2014;3:1-5.
15. Ralapanawa U, Alawattegama AT, Gunrathne M, Tennakoon S, Kularatne SA, Jayalath T. Value of peripheral blood count for dengue severity prediction. BMC Res Notes. 2018;11(1):400. doi: 10.1186/s13104-018-3505-4.
16. Kao CL, King CC, Chao DY, Wu HL, Chang GJ. Laboratory diagnosis of dengue virus infection: current and future perspectives in clinical diagnosis and public health. J Microbiol Immunol Infect. 2005;38(1):5-16.
17. Ageep AK, Malik AA, Elkarsani MS. Clinical presentations and laboratory findings in suspected cases of dengue virus. Saudi Med J. 2006;27(11):1711-1713.
18. Advani S, Agarwal S, Verma J. Haemogram profile of dengue fever in adults during 19 September – 12 November 2008: A study of 40 cases from Delhi. Dengue Bulletin 2011;35:71-75.
19. Rusmawati I, Asma Hanim H, Naznin M, Salman MS, Norlelawati AT. A descriptive study of blood films of patients serologically positive for dengue in Hospital TengkuAmpuanAfzan, Kuantan. Int Med J Malaysia. 2010;9(2):35-37.
20. Dutta P, Khan SA, Borah J, Mahanta J. Demographic and clinical features of patients with dengue in Northeastern region of India: A retrospective cross-sectional study during 2009-2011. J Virol Microbiol 2012;2012:1-11. doi: 10.5171/2012.786298
21. Arshad I, Malik FA, Hussain A, Shahida A. Dengue fever clinico-pathologic correlations and their association with poor outcome. Professional Med J. 2011;18(1):57-63.
22. Jameel T, Mehmood K, Mujtaba G, Choudhry N, Afzal N, Paul RF. Changing haematological parameters in dengue viral infections. J Ayub Med Coll Abbottabad. 2012;24(1):3-6.
23. Rashmi MV, Hamsaveena. Haematological and biochemical markers as predictors of dengue infection. Malaysian J Pathol. 2015;37(3):247-251.
24. Joshi AA, Gayathri BR, Muneer F. Dynamics of differential count in dengue. Int J Adv Med 2018;5(1): 145-150.doi: http://dx.doi.org/10.18203/2349-3933.ijam 20180074
25. Harnett WL. The Differential Blood Count in Dengue. Ind Med Gaz. 1913;48(2):45-49.
26. Cabar FR, Fettback PB, Pereira PP, Zugaib M. Serum markers in the diagnosis of tubal pregnancy. Clinics (Sao Paulo). 2008;63(5):701-8. doi:10.1590/ s1807-59322008000500021
27. Khandal A, Raghuraman D. Rising Mean Platelet Volume (MPV) Heralding Platelets Recovery in Dengue? Am J Clin Med Res. 2017;5(4):59-63. doi: 10. 12691/ajcmr-5-4-5
28. Navya B.N, Patil S, Kariappa TM. Role of Platelet Parameters in Dengue Positive Cases - An Obser-vational Study. Int J Health Sci Res 2016;6(6):74-78.
29. Vagdatli E, Gounari E, Lazaridou E, et al. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia. 2010; 14(1):28-32.
30. Bashir AB, Saeed OK, Mohammed BA, Ageep AK. Role of Platelet Indices in Patients with Dengue Infection in Red Sea State, Sudan. Int J Sci Res 2015; 4(1):1573-1576.
31. Gawlita M,Wasilewski J, Osadnik T, Regula R, Bujak K, Gonera M. Mean platelet volume and platelet large cell ratio as prognostic factors for coronary artery disease and myocardial infarction. Folia Cardiologica 2015;10(6):418-422. doi: 10.5603/FC.2015.0079
OAI - Open Archives Initiative
