Spectrum of febrile thrombocytopenia among children in a tropical country-a hospital based observational study in South India

Authors

  • Karthikraj T. Department of Pediatrics, Velammal Medical College Hospital, Madurai, Tamil Nadu, India http://orcid.org/0000-0003-3699-250X
  • Jenish Rajma J. Department of Pediatrics, Velammal Medical College Hospital, Madurai, Tamil Nadu, India
  • Jeyabalaji R. V. Department of Pediatrics, Velammal Medical College Hospital, Madurai, Tamil Nadu, India
  • Shivani Kuttuva Department of Pediatrics, Velammal Medical College Hospital, Madurai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20210128

Keywords:

Febrile thrombocytopenia, Tropical country, Dengue

Abstract

Background: Febrile thrombocytopenia is a common reason for pediatric admission. Though infections are the major cause, noninfectious causes are not uncommon. This study was done to estimate the prevalence of thrombocytopenia as a presentation in pediatric fever cases, to analyze the various etiologies, presentations and relationship between platelet count and the severity of disease and prognosis.

Methods: Retrospective observational study done by collecting data from hospital records of children admitted in Velammal Medical college hospital from January 2016 to December 2017. Children in the age group of 6 months to 15 years with fever and thrombocytopenia at admission were included in the study. Children on treatment with anti-platelet drugs, other chronic diseases and infants less than 6 months were excluded.

Results: Out of 2523 fever cases admitted, 372 children fulfilled this criterion. 70% had positive dengue serology, other infectious causes were other viral hemorrhagic fevers, complicated enteric fever, scrub typhus and sepsis. The predominant non-infectious causes were hematological malignancies, Idiopathic thrombocytopenic purpura and Hemolytic uremia syndrome.

Conclusions: Febrile thrombocytopenia is a common clinical presentation in children in dengue endemic areas. Most viral fevers have leukopenia but presence of thrombocytopenia with warning signs like pain abdomen, vomiting or oliguria should prompt suspicion of dengue. Infections like enteric fever, scrub typhus or chikungunya may also mimic similar findings. Rarely diseases like leukemia, Idiopathic thrombocytopenic purpura, Hemolytic uremic syndrome or Sepsis may also present as febrile thrombocytopenia. The need for antibiotics or blood products is very minimal.

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References

Nagler M, Keller P, Siegrist D, Alberio L. A case of EDTA dependent pseudo-thrombocytopenia: simple recognition of under diagnosed and misleading phenomenon. BMC Clin Pathol. 2014;14:19.

Simmons CP, Farrar JJ, Nguyen V, Wills B. Dengue. N Engl J Med. 2012;366:1423-32.

Sujatha R, Pushpalatha K, Bharathi K, Udaya R, Hareesh S. An aetiological profile of febrile thrombocytopenia in children. Sri Lanka J Child Health. 2018;47;146-8.

Herbinger KH, Schunk M, Nothdruft HD, Von Sonnenburg F, Loscher T, Bretzel G. A comparative study on infection induced thrombocytopenia among returned travellers. Infection. 2012;40:373-9.

Malik AS. Complications of bacteriologically confirmed typhoid fever in children. J Trop Paediatr. 2002;48:102-8.

Nair Bindu T, Kuldeep S, Sandeep PD. A study of clinical and laboratory profile of febrile children presenting with thrombocytopenia. Int J Contem Pediatr. 2017;4(6):2114-9.

Phakhounthong K, Chaovalit P, Jittamala P. Predicting the severity of dengue fever in children on admission based on clinical features and laboratory indicators: application of classification tree analysis. BMC Pediatr. 2018;18:109.

Harsha NS, Thimma Reddy TR, Shruthi M, Ravishankar SN, Madhuvan HS. A Study of Clinical and Laboratory Profile of Fever with Thrombocytopenia. J clin biomed sci. 2016;6:121-4.

Radhika BV, Sooraj CS, Kamath V. Section: Medicine A Study of Febrile Thrombocytopenia Section. Medicine. 2019;6:21-5.

Subramanian V, Santosh K. Thrombocytopenia in children: a clinico-etiological profile in an urban tertiary care hospital. Int J Contem Pediatr. 2018;6:131.

Kshirsagar P, Chauhan S, Samel D. Towards Developing a Scoring System for Febrile Thrombocytopenia. The J Asso Physicians India. 2016;64(2):14-8.

Selvan T, Nagaraj MV, Saravanan P, Somashekar. A study of clinical profile of dengue fever in children. Int J Contemp Pediatr. 2017;4:534.

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Published

2021-01-22

How to Cite

T., K., J., J. R., R. V., J., & Kuttuva, S. (2021). Spectrum of febrile thrombocytopenia among children in a tropical country-a hospital based observational study in South India. International Journal of Contemporary Pediatrics, 8(2), 354–359. https://doi.org/10.18203/2349-3291.ijcp20210128

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Original Research Articles