THE ASSOCIATION OF IMMATURE PLATELET FRACTION LEVELS WITH BLEEDING MANIFESTATIONS IN PATIENTS WITH SEVERE THROMBOCYTOPENIA IN DENGUE FEVER: A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

Background and objectives: Dengue ranges from asymptomatic to severe forms like dengue haemorrhagic fever. Severe cases often show thrombocytopenia and bleeding. The Immature Platelet Fraction (IPF) indicates reticulated platelets and helps predict platelet recovery in dengue. This study examined the association between immature platelet fraction and bleeding in dengue patients, plus IPF’s role in predicting platelet recovery.

Methods: Seventy-five patients with dengue fever and severe thrombocytopenia (platelet count < 25,000 cells/µl) participated after signing the informed consent. IPF was measured and classified as <10 or≥10. Platelet counts were checked after 24 and 48 hours. The correlation between IPF, bleeding manifestations, and platelet recovery was analysed.

Results: Our study showed (M: F 2:1), with 77.3% of patients aged 18-39 years. Common comorbidities were diabetes mellitus and hypertension. Fever affected (98.7%) patients, followed by myalgia (94.6%), fatigue (92%), and gastrointestinal symptoms (64%). Bleeding occurred in (28%), including mucocutaneous (16%), gastrointestinal (8%), and genitourinary (6.7%). Mean platelet count rose from 12,015 (±5,055.05)/µl at baseline to 45,318 (±20,829.83)/µl at 48 hours. Most patients (74.6%) had IPF ≥10, which was associated with lower bleeding risk (p=0.001) but a nonsignificantly higher platelet increment (p=0.262). Blood transfusion was required in 12/75 patients; 3/12 had no bleeding.

Conclusion: The study found that dengue patients with severe thrombocytopenia and an immature platelet fraction (IPF) ≥ 10 had lower bleeding and a faster platelet recovery than those with an IPF < 10, predicting bleeding risk and guiding platelet transfusions, but further research is needed.