Prophyactic platelet transfusion in stable dengue Fever patients: is it really necessary?
Our hospital is a referral centre for Jehovah's Witnesses (JW) patients, who as a matter of religious belief refuse transfusions of blood/blood components. We have treated JW patients with dengue fever (DF) and thrombocytopenia without platelet transfusion, without any mortality or major morbidities. We retrospectively compared the duration needed for platelet recovery and duration of hospitalization of DF with thrombocytopenia in those treated with prophylactic platelet transfusion and JW patients who were managed without these. Among JW patients, platelet counts recovered to >50,000 in 2.57 days (Mean) as compared to those who received prophylactic platelet transfusion, who recovered in 4.43 days (P value < 0.0001). They also had significantly less number of days of hospitalization (3.68 days vs 5.13 days, P value < 0.0001). These differences persisted even when a subgroup analysis of patients who had nadir platelet count less than 10,000 were done. Most importantly, none of the patients in either group suffered any significant morbidity or mortality. Prophylactic platelet transfusion in clinically stable DF patients was associated with significant delay in platelet recovery and increased duration of hospitalization, even though was not harmful in terms of morbidity or mortality. Though number of subjects involved in the study was small, this brief report further adds to the current evidence that prophylactic platelet transfusion in clinically stable DF patients with a platelet count more than 10,000/cmm is not indicated.
Department of Hematology, Narayana Hrudayalaya Multispecialty Hospital and Mazumdar Shaw Cancer Centre, Bangalore, Karnataka 560099 India ; Department of Hemato-Oncology and Bone Marrow Transplant Unit, Narayana Hrudayalaya-Mazumdar Shaw Cancer Centre, No. 258/A, Bomasandra Industrial Area, Anekal Taluk, Bangalore, 560099 Karnataka India.
B
B
Prashantha
Department of Internal Medicine and Pulmonology, Narayana Hrudayalaya Multispecialty Hospital and Mazumdar Shaw Cancer Centre, Bangalore, 560099 Karnataka India.
S
S
Varun
Department of Hematology, Narayana Hrudayalaya Multispecialty Hospital and Mazumdar Shaw Cancer Centre, Bangalore, Karnataka 560099 India.
Damodar
D
Sharat
Department of Internal Medicine and Pulmonology, Narayana Hrudayalaya Multispecialty Hospital and Mazumdar Shaw Cancer Centre, Bangalore, 560099 Karnataka India.
B V
BV
Murali Mohan
Department of Internal Medicine and Pulmonology, Narayana Hrudayalaya Multispecialty Hospital and Mazumdar Shaw Cancer Centre, Bangalore, 560099 Karnataka India.
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R
Ranganatha
Department of Medicine and Intensive Care, Narayana Hrudayalaya Multispecialty Hospital and Mazumdar Shaw Cancer Centre, Bangalore, 560099 Karnataka India.
Shivaprasad
Department of Internal Medicine and Pulmonology, Narayana Hrudayalaya Multispecialty Hospital and Mazumdar Shaw Cancer Centre, Bangalore, 560099 Karnataka India.
Manchal
M
Naveen
Dengue fever (DF); Jehovah’s Witnesses (JW); Platelet transfusion (PT)