Thrombocytopenia and raised hematocrit-predictor in dengue hemorrhagic fever


  • Nisha Upadhyay Department of Pediatrics, GMERS Medical College, Gandhinagar, Gujrat, India
  • Himanshu Joshi Department of Pediatrics, GMERS Medical College, Gandhinagar, Gujrat, India
  • Chintan Upadhyay Department of Obstetrics and Gynecology, GMERS Medical College, Gandhinagar, Gujrat, India



Dengue hemorrhagic fever, Hematocrit, Thrombocytopenia


Background: This study evaluated the symptoms and routine laboratory investigation to arrive at a bedside diagnosis of dengue hemorrhagic fever and to predict the prognosis on the basis of clinical features and investigation.

Methods: This was a prospective study and included children age up to 15 years admitted in the pediatric ward over 2 years period. Dengue fever and dengue hemorrhagic fever were defined according to WHO guidelines.

Results: Out of 90 Dengue positive children 44 (48.8%) were of Dengue Hemorrhagic Fever. The common clinical features were fever (100%), bleeding (100%), and rash (84%). 100% children had thrombocytopenia and 36% had raised hematocrit.

Conclusions: Triad of fever, bleeding tendencies and rash along with thrombocytopenia and raised hematocrit can be considered as predictive marker for the early diagnosis of dengue hemorrhagic Fever before the specific test like NS1 antigen and antibodies are available. 


World Health Organization. Dengue Hemorrhagic Fever: diagnosis, treatment and control, Geneva, 2nd edition. World health organization; 1998.

Kittigul L, Pitakarnjanakul P, Sujirarat D, Siripanichgon K. The differences of clinical manifestations and laboratory findings in children and adults with dengue virus infection. J Clinic Virol. 2007;39(2):76-81.

Gupta N, Srivastava S, Jain A, Chaturvedi U. Dengue in India. Indian J Med Res. 2012;136(3): 373-90.

Shah I, Deshpande GC and Tardeja PN. Outbreak of Dengue in Mumbai and Predictive markers for DSS. J Tropic Paediatr. 2004,50(5):301-5.

Butt N, Munir SM, Ahmed SM, Sheikh QH. Haematological and biochemical indicators for the early diagnosis of dengue viral infection. J Coll Physicians Surg Pak. 2008;18(5):282-5

Capeding MR, Manalaysay M, Rivera RG, Kristy Sy A, Tayag EG. Laboratory confirmed Dengue in chilfren in three regional hospitals in the Philippines. Pediatr Infectious Dis J. 2015;34 (11):1145-51.

Lee MS, Hwang KP, Chen TC, Lu PL, Chen TP. Clinical characteristics of dengue and dengue hemorrhagic fever in a medical center of Southern Taiwan during the 2002 epidemic. J Microbial Immunol infect. 2006;39(2):121-9.

Kabra SK, Jain Y, Madhulika, Tripathi P, Singhal T, Broor S, et al. Role of platelet transfusion in Dengue Hemorrhagic fever. Ind Pediatr. 1998;35:452-5.

Hunter RF, Morales R, Garcia S, Dengue fever with thrombocytopenia. Studies towards defining vulnerability of bleeding. Bol Asoc Med PR. 1995;87(1-2):2-7.

Abbasi A, Butt N, Sheikh QH, Munir SM, Ahmed SM. Clinical features, diagnositic techniques and management of dual dengue and malaria infection. J Coll Physician Surg Pak. 2009;19(1):25-9.

Joshi H, Seema Shah. Platlet count- a diagnostic aid in Fever. National J Integrated Res Med. 2013;4(3):128-32.






Original Research Articles