2018Indian Journal of Pathology and OncologyOpen access

Study of Leukopenia as haematological parameter, to find it’s diagnostic rationale in dengue patients

Jagjeevan Ram, Manoj Gupta, Poonam Rani, Kamlesh Kumar, Amrita Amrita

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Abstract

Introduction: The dengue fever is in the form of epidemic in India which occurs usually after rainy season. There is need of adjuvant haematological parameters that can at very initial stage differentiate the dengue fever from other viral fever which are prevalent at the same time. Aims and Objectives: This retrospective study was carried out to find association of leukopenia with dengue fever. As screening test for dengue fever are not available in remote areas, so we had tried to access diagnostic power of leukopenia in dengue fever along with thrombocytopenia. Materials and Methods: Total 520 cases had been taken. Out of these 220 cases were positive for dengue fever as confirmed on dengue fever ELISA test for NS1 and/or IgM. Retrieved data were analysed for platelet counts and total leukocyte counts. Results: In Total 220 cases of dengue fever, 101 cases had shown both leukopenia and thrombocytopenia. While in 300 normal cases there were only 2 cases of leukopenia along with thrombocytopenia. The sensitivity of leukopenia alone for diagnosis of dengue fever was only 50.91%, but the specificity was 98.33%. Positive Likelihood Ratio (PLR) of leukopenia to dengue fever was 30.55. Although the sensitivity was decreased to 45.91% if leukopenia with thrombocytopenia was used as diagnostic tool for dengue fever, but specificity was increased up to 99.33% with PLR up to 68.86. The total leukocyte count and platelets were statistically reduced with extreme significance (P p Conclusion: The leukopenia alone is highly specific for dengue fever, but if combined with thrombocytopenia, specificity is further increased. Both Leukopenia and thrombocytopenia were statistically extremely significant (P Keywords: Dengue fever, Leukopenia, ELISA, Platelet count, Thrombocytopenia.

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Introduction: The dengue fever is in the form of epidemic in India which occurs usually after rainy season. There is need of adjuvant haematological parameters that can at very initial stage differentiate the dengue fever from other viral fever which are prevalent at the same time. Aims and Objectives: This retrospective study was carried out to find association of leukopenia with dengue fever. As screening test for dengue fever are not available in remote areas, so we had tried to access diagnostic power of leukopenia in dengue fever along with thrombocytopenia. Materials and Methods: Total 520 cases had been taken. Out of these 220 cases were positive for dengue fever as confirmed on dengue fever ELISA test for NS1 and/or IgM. Retrieved data were analysed for platelet counts and total leukocyte counts. Results: In Total 220 cases of dengue fever, 101 cases had shown both leukopenia and thrombocytopenia. While in 300 normal cases there were only 2 cases of leukopenia along with thrombocytopenia. The sensitivity of leukopenia alone for diagnosis of dengue fever was only 50.91%, but the specificity was 98.33%. Positive Likelihood Ratio (PLR) of leukopenia to dengue fever was 30.55. Although the sensitivity was decreased to 45.91% if leukopenia with thrombocytopenia was used as diagnostic tool for dengue fever, but specificity was increased up to 99.33% with PLR up to 68.86. The total leukocyte count and platelets were statistically reduced with extreme significance (P p Conclusion: The leukopenia alone is highly specific for dengue fever, but if combined with thrombocytopenia, specificity is further increased. Both Leukopenia and thrombocytopenia were statistically extremely significant (P Keywords: Dengue fever, Leukopenia, ELISA, Platelet count, Thrombocytopenia.

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Available abstract

Introduction: The dengue fever is in the form of epidemic in India which occurs usually after rainy season. There is need of adjuvant haematological parameters that can at very initial stage differentiate the dengue fever from other viral fever which are prevalent at the same time. Aims and Objectives: This retrospective study was carried out to find association of leukopenia with dengue fever. As screening test for dengue fever are not available in remote areas, so we had tried to access diagnostic power of leukopenia in dengue fever along with thrombocytopenia. Materials and Methods: Total 520 cases had been taken. Out of these 220 cases were positive for dengue fever as confirmed on dengue fever ELISA test for NS1 and/or IgM. Retrieved data were analysed for platelet counts and total leukocyte counts. Results: In Total 220 cases of dengue fever, 101 cases had shown both leukopenia and thrombocytopenia. While in 300 normal cases there were only 2 cases of leukopenia along with thrombocytopenia. The sensitivity of leukopenia alone for diagnosis of dengue fever was only 50.91%, but the specificity was 98.33%. Positive Likelihood Ratio (PLR) of leukopenia to dengue fever was 30.55. Although the sensitivity was decreased to 45.91% if leukopenia with thrombocytopenia was used as diagnostic tool for dengue fever, but specificity was increased up to 99.33% with PLR up to 68.86. The total leukocyte count and platelets were statistically reduced with extreme significance (P p Conclusion: The leukopenia alone is highly specific for dengue fever, but if combined with thrombocytopenia, specificity is further increased. Both Leukopenia and thrombocytopenia were statistically extremely significant (P Keywords: Dengue fever, Leukopenia, ELISA, Platelet count, Thrombocytopenia.

Key concepts: Leukopenia, Dengue fever, Medicine, Internal medicine, Immunology, Gastroenterology, Virology, Chemotherapy

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