THROMBOCYTOPENIA AND PLATELET TRANSFUSIONS IN CLINICALLY SUSPECTED DENGUE HAEMORRHAGIC FEVER AND DENGUE SHOCK SYNDROME

The presence of thrombocytopenia was determined in 1300 patients with clinically suspected Dengue Haemorrhagic Fever (DHF) (1198; 92%) and Dengue Shock Syndrome (DSS) (102; 8%), admitted to 4 major hospitals in Bandung, Indonesia. A dengue serological test was performed on 1100 (85%) of the 1300 patients. In 763 (69%) of them evidence was found of a present or previous Dengue infection. Of all clinically diagnosed DHF/DSS patients, thrombocyte counts of less than 100.000/μl were present in 445 of 1300 (34%) patients on admission and in 637 (49%) during hospitalization. Severe bleeding was recorded in 76 (6%) of all 1300 clinically suspected DHF/DSS cases and occurred more often in patients with severe thrombocytopenia. One hundred and fifty six (12%) of all clinically suspected DHF/DSS cases received a platelet transfusion, among them only 30 (19%) had a platelet count below 25.000/μl. No difference in the frequency of bleeding was observed comparing patients who received or did not receive a platelet transfusion (even in those with a platelet count < 25.000/μl). In conclusion, a relatively large number of patients with clinically suspected DHF/DSS in Bandung Hospitals receive platelet transfusions, even if thrombocyte counts are above 25.000/μl. This study suggests that in most DHF/DSS cases platelet transfusions do not influence the incidence of severe bleeding in DHF/DSS cases. Treatment costs for DHF/DSS cases could be reduced if these unnecessary platelet transfusions were not given.