Use of Mean platelet Volume as an initial diagnostic marker in evaluation of dengue fever
Keywords:
Dengue Fever, mean platelet volume, MPV
Abstract
Background: Dengue fever is the most rapidly spreading mosquito-borne viral disease. Four main characteristic manifestations of dengue illness are (i) continuous high fever lasting 2-7 days; (ii) haemorrhagic tendency as shown by a positive tourniquet test, petechiae or epistaxis; (iii) thrombocytopoenia (platelet count <100×109/l); and (iv) evidence of plasma leakage manifested by haemoconcentration (an increase in haematocrit 20% above average for age, sex and population), pleural effusion and ascites, etc. Recently, novel platelet indices such as MPV, PDW, and P-LCR have been investigated as prospective platelet activation markers .Platelet volume, a marker of platelet function and activity is measured as mean platelet volume (MPV) by hematology analyzer.Method: The study was done with the aim to assess whether mean platelet volume has any diagnostic importance in the initial evaluation of dengue fever . 45 adult patients were diagnosed with Dengue NS1 antigen positivity and underwent routine complete blood counts on automated hematology analyser HORIBA Pentra ES60.Result: A total of 76 cases ranging from 6 months to 50 years of age were reported as antigenically positive for dengue indicating acute infection, out of which 45 were adults ranging from 12 to 50 years of age. 34 were male and 11 were female. Infants and children below 12 years of age were not included in this study. 55 controls were studied which included 31 males and 24 females. The mean platelet volume was found to be significantly higher in dengue cases when compared to controls. MPV was also noted to be significantly higher in patients with platelet count below the normal biological reference range of 1.5 lakhs ,when compared to dengue patients with normal platelet counts.Conclusion: To conclude, high MPV indicates platelet activation and may be used as an initial marker to suspect dengue fever in a case of thrombocytopenia.References
1. WHO. Dengue hemorrhagic fever: Diagnosis, treatment, prevention and control. Geneva: WHO press; 2009:3-106.
2. Dengue: Guidelines for diagnosis, treatment, prevention, and control in sub-Saharan Africa and 13 countries in South America. Geneva: World Health Organization; 2009. WHO.
3. Dacie and Lewis Practical Hematology 11th edition:47-48
4. Sharma K, Yadav A. Association of Mean Platelet Volume with Severity, Serology & Treatment Outcome in Dengue Fever: Prognostic Utility J Clin Diagn Res. 2015; 9(11): EC01–EC03
5. Anker M, Arima Y. Male-female differences in the number of reported incident dengue fever cases in six Asian countries. Western Pacific Surveillance and Response Journal. 2011, 2(2):17-23. doi:10.5365/wpsar.2011.2.1.002
6. Guha-Sapir D, Schimmer B. Dengue fever: New paradigms for a changing epidemiology. Emerg Themes Epidemiol 2005;2:1.
7. Agarwal R, Kapoor S, Nagar R, Misra A, Tandon R, Mathur A, et al. A clinical study of the patients with dengue hemorrhagic fever during the epidemic of 1996 at Lucknow, India. Southeast Asian J Trop Med Public Health 1999;30:735-40.
8. Ray G, Kumar V, Kapoor AK, Dutta AK, Batra S. Status of antioxidants and other biochemical abnormalities in children with dengue fever. J Trop Pediatr 1999;45:4-7.
9. Wali JP, Biswas A, Handa R, Aggarwal P, Wig N, Dwivedi SN. Dengue haemorrhagic fever in adults: A prospective study of 110 cases. Trop Doct 1999;29:27-30.
10. McMillan R. Therapy for adults with refractory chronic immune thrombocytopenic purpura. Ann Intern Med 1997;126:307-314
11. Cecilia D. Current status of dengue and chikungunya in India. WHO South-East Asia Journal of Public Health | Jan-Mar 2014 | 3 (1) 22-27
12. Karpatkin S. Heterogeneity of human platelets. VI. Correlation of platelet function with platelet volume. Blood 1978;51:307-316
13. Wintrobe’s Clinical Heamatology, 11th edition: 632
14. Basu A, Jain P, Gangodkar S, Shetty S, Ghosh K. Dengue 2 virus inhibits in vitro megakaryocytic colony formation and induce apoptosis in thrombopoietin-inducible megakaryocytic differentiation from cord blood CD34+ cells. FEMS Immunol Med Microbiol. 2008;53:46–51.
15. Ghosh K, Gangodkar S, Jain P, Shetty S, Ramjee S, Poddar P, et al. Imaging the interaction between dengue 2 virus and human blood platelets using atomic force and electron microscopy. J Electron Microsc. 2008;57:113–8.
16. Budak YU, Polat M, Huysal K. The use of platelet indices, plateletcrit, mean platelet volume and platelet distribution width in emergency non-traumatic abdominal surgery: a systematic review. Biochemia Medica. 2016;26(2):178-193.
17. Prakash GM, Anikethana G V. Use of mean platelet volume and platelet distribution width in predicting trend in platelet count and bleeding risks in patients of dengue fever. Int J Adv Med 2016;3:611-3.
18. Dewi YP. Mean Platelet Volume (MPV): Potential Predictor of Disease Severity in Dengue infection. In proceeding of: International Dengue Symposium. 2013 conference paper.
19. Wiwanitkit V. Mean platelet volume in the patients with dengue hemorrhagic fever. Platelets. 2004;15(3):185.
20. Bashir AB, Saeed OK, Mohammed BA, Ageep AK. Role of Platelet Indices in Patients with Dengue Infection in Red Sea State, Sudan. International Journal of Science and Research 2015;4:1573-1576
2. Dengue: Guidelines for diagnosis, treatment, prevention, and control in sub-Saharan Africa and 13 countries in South America. Geneva: World Health Organization; 2009. WHO.
3. Dacie and Lewis Practical Hematology 11th edition:47-48
4. Sharma K, Yadav A. Association of Mean Platelet Volume with Severity, Serology & Treatment Outcome in Dengue Fever: Prognostic Utility J Clin Diagn Res. 2015; 9(11): EC01–EC03
5. Anker M, Arima Y. Male-female differences in the number of reported incident dengue fever cases in six Asian countries. Western Pacific Surveillance and Response Journal. 2011, 2(2):17-23. doi:10.5365/wpsar.2011.2.1.002
6. Guha-Sapir D, Schimmer B. Dengue fever: New paradigms for a changing epidemiology. Emerg Themes Epidemiol 2005;2:1.
7. Agarwal R, Kapoor S, Nagar R, Misra A, Tandon R, Mathur A, et al. A clinical study of the patients with dengue hemorrhagic fever during the epidemic of 1996 at Lucknow, India. Southeast Asian J Trop Med Public Health 1999;30:735-40.
8. Ray G, Kumar V, Kapoor AK, Dutta AK, Batra S. Status of antioxidants and other biochemical abnormalities in children with dengue fever. J Trop Pediatr 1999;45:4-7.
9. Wali JP, Biswas A, Handa R, Aggarwal P, Wig N, Dwivedi SN. Dengue haemorrhagic fever in adults: A prospective study of 110 cases. Trop Doct 1999;29:27-30.
10. McMillan R. Therapy for adults with refractory chronic immune thrombocytopenic purpura. Ann Intern Med 1997;126:307-314
11. Cecilia D. Current status of dengue and chikungunya in India. WHO South-East Asia Journal of Public Health | Jan-Mar 2014 | 3 (1) 22-27
12. Karpatkin S. Heterogeneity of human platelets. VI. Correlation of platelet function with platelet volume. Blood 1978;51:307-316
13. Wintrobe’s Clinical Heamatology, 11th edition: 632
14. Basu A, Jain P, Gangodkar S, Shetty S, Ghosh K. Dengue 2 virus inhibits in vitro megakaryocytic colony formation and induce apoptosis in thrombopoietin-inducible megakaryocytic differentiation from cord blood CD34+ cells. FEMS Immunol Med Microbiol. 2008;53:46–51.
15. Ghosh K, Gangodkar S, Jain P, Shetty S, Ramjee S, Poddar P, et al. Imaging the interaction between dengue 2 virus and human blood platelets using atomic force and electron microscopy. J Electron Microsc. 2008;57:113–8.
16. Budak YU, Polat M, Huysal K. The use of platelet indices, plateletcrit, mean platelet volume and platelet distribution width in emergency non-traumatic abdominal surgery: a systematic review. Biochemia Medica. 2016;26(2):178-193.
17. Prakash GM, Anikethana G V. Use of mean platelet volume and platelet distribution width in predicting trend in platelet count and bleeding risks in patients of dengue fever. Int J Adv Med 2016;3:611-3.
18. Dewi YP. Mean Platelet Volume (MPV): Potential Predictor of Disease Severity in Dengue infection. In proceeding of: International Dengue Symposium. 2013 conference paper.
19. Wiwanitkit V. Mean platelet volume in the patients with dengue hemorrhagic fever. Platelets. 2004;15(3):185.
20. Bashir AB, Saeed OK, Mohammed BA, Ageep AK. Role of Platelet Indices in Patients with Dengue Infection in Red Sea State, Sudan. International Journal of Science and Research 2015;4:1573-1576
Published
2017-07-12
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