Dengue fever: predictors of spontaneous bleeding in dengue fever

Background: Dengue fever (DF) is a mosquito-transmitted disease caused bythe dengue virus, an enveloped, single stranded RNA virus of flaviridae family. DF is widelydistributed in many countries of southeast and southern Asia, Central and South America, andthe Western Pacific regions. Dengue fever (DF) has emerged as an epidemic in Pakistan forthe past few years. Objectives: To identify the predictive factors for spontaneous bleedingmanifestations in Dengue fever. Study Design: Descriptive case series. Settings: Pathologydepartment of King Edward Medical University and affiliated hospitals (Mayo Hospital andLady Aitchison Hospital). Study Period: Four months of dengue epidemic July-October 2011.Material and Methods: This study included 125 patients with DF. Patients with spontaneousbleeding were identified. Coagulation profile (including platelet count, prothrombin time(PT) and activated partial thromboplastin time (APTT) were recorded in each group (Withand without bleeding). Results: Spontaneous bleeding during dengue fever occurred in53(42.4%) patients. The mean coagulation profile in patients of dengue fever with and withoutspontaneous bleeding was as follows: platelets (91.28±26.64X109/L versus 112.10±17.12 X109/L, p<0.05), PT (15.72±2.42 versus 14.47±3.70 seconds, P>0.05), and APTT (41.0±24.00versus 36.65±4.65 seconds), p<0.05). Conclusions: Frequency of spontaneous bleeding inDF was high. A raised APTT and lower platelets counts was found in patients of dengue feverwith bleeding as compared to non bleeders while no difference in PT levels in both groups.