Start Submission Become a Reviewer

Reading: Association of abnormal coagulation tests with Dengue virus infection and their significance...

Download

A- A+
Alt. Display

Original Articles

Association of abnormal coagulation tests with Dengue virus infection and their significance as early predictors of fluid leakage and bleeding

Authors:

Sanjaya Kulasinghe ,

District General Hospital, Vavuniya, LK
About Sanjaya
Acting Paediatrician, District General Hospital, Vavuniya, Sri Lanka
X close

Ramya Ediriweera,

Lady Ridgeway Hospital, Colombo, LK
About Ramya
Consultant Paediatrician, Lady Ridgeway Hospital, Colombo, Sri Lanka
X close

Pradeep Kumara

Teaching Hospital Anuradhapura, LK
About Pradeep
Paediatric Registrar, Teaching Hospital, Anuradhapura, Sri Lanka
X close

Abstract

Introduction: Dengue virus infection is endemic in Sri Lanka and is a major health concern. Fluid leakage and bleeding are important features in the spectrum of symptomatic dengue. Several laboratory tests have been evaluated for their association with dengue in order to find a predictor of complications.

Objective: To find the association of blood coagulation tests with dengue virus infection and their significance as early predictors of leaking and bleeding.

Method: A prospective study was carried out in ward 8, Lady Ridgeway Hospital on 384 patients admitted with a non-specific febrile illness without clinical features of fluid leakage or bleeding. They were followed up clinically to detect features of leaking and bleeding and with serial coagulation tests [Activated partial thromboplastin time (APTT) and international normalized ratio (INR)] and liver enzymes. Data analysis was done to detect associations between dengue and these tests.

Results: Eighty three patients with dengue haemorrhagic fever (DHF) and 75 patients with dengue fever (DF) were identified. Twelve DHF patients and 1 DF patient had bleeding manifestations. A statistically significant association was seen between abnormal coagulation results and DHF/bleeding when compared with DF. Ninety five percent had a raised APTT and 12% had a raised INR before leaking. One hundred percent had raised APTT and 46% had raised INR before bleeding. APTT had a good sensitivity and specificity as a predictor while INR was low in sensitivity and high in specificity. Liver transaminases also showed a positive correlation but lacked specificity.

Conclusion In febrile patients with dengue virus infection raised APTT and INR are significantly associated with leaking and bleeding and so are the liver enzymes alanine transaminase (ALT) and aspartate transaminase (AST). Out of the laboratory parameters studied day 4 and day 5 APTT is the best predictor of leaking and bleeding. INR and liver transaminases could be used as supportive predictors.

How to Cite: Kulasinghe, S., Ediriweera, R. and Kumara, P., 2016. Association of abnormal coagulation tests with Dengue virus infection and their significance as early predictors of fluid leakage and bleeding. Sri Lanka Journal of Child Health, 45(3), pp.184–188. DOI: http://doi.org/10.4038/sljch.v45i3.8031
Published on 05 Sep 2016.
Peer Reviewed

Downloads

  • PDF (EN)

    comments powered by Disqus