Skip to main content
Log in

Predictors of spontaneous bleeding in Dengue

  • Original Article
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objective : To identify the predictive factors for spontaneous bleeding manifestations in Dengue illness in infants and children.Methods : 60 cases of Dengue viral infection with spontaneous skin and or mucosal bleed were compared with 72 cases without spontaneous bleed. The protean bleeding manifestations in dengue infection were recorded. Various clinical and laboratory parameters were analyzed using univariate and logistic regression analysis.Results and Conclusion : Prothombin time was abnormal only in cases with spontancous bleed. A combination of (a) biphasic pattern of fever, (b) hemoconcentration, (c) platelet count less than 50,000/ mm3 and (d) elevated ALT had a sensitivity of 79.2%, specificity of 64.7% with a positive predictive value of 70% and a negative predictive value of 75% in predicting spontaneous bleeding in dengue.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Halstead SB. Dengue fever/dengue hemorrhagic fever. In Behrman RE, Kliegman RM, Jenson HB, eds.Nelson Textbook of Pediatrics, 16th edn. WB Saunders Company, 2000; 1005–1007.

  2. Anuradha S, Singh NP, Rizvi SN, Agarwal SK, Gur R, Mathur MD. The 1996 outbreak of dengue hemorrhagic fever in Delhi, India.South East Asian J Tropical Medicine Public Health 1998; 29 (3): 503–506.

    CAS  Google Scholar 

  3. World Health Organization.Dengue Hemorrhagic Fever: Diagnosis, Treatment and Control, Geneva, 2nd edn. World Health Organization, 1998.

    Google Scholar 

  4. Huang YH, Liu CC, Wang ST, Lei HY, Liu HL, Lin YSet al. Activation of coagulation and nbrinolysis during dengue virus infection.J Medical Virology 2001; 63 (3): 247–251.

    Article  CAS  Google Scholar 

  5. Mitrakul C, Poshyachinda M, Futrakul P, Sangkawibha N, Ahandrik S. Hemostatic and platelet kinetic studies in Dengue Hemorrhagic fever.American J Tropical Medicine Hygiene 1977; 26:975–984.

    CAS  Google Scholar 

  6. Gomber S, Ramachandran VG, Kumar S, Agarwal KN, Gupta P, Dewan DKet al. Hematological observations as diagnostic markers in dengue hemorrhagic fever — A reappraisal.Indian Pediatr 2001; 38: 477–481.

    PubMed  CAS  Google Scholar 

  7. Aggarwal A, Chandra J, Aneja S, Patwari AK, Dutta AK. An epidemic of Dengue Hemorrhagic fever and Dengue shock syndrome in children in Delhi.Indian Pediatr 1998; 35: 727–732.

    PubMed  CAS  Google Scholar 

  8. Chairulfatah A, Setiabudi D, Ridad A, Colebunders R. Clinical manifestations of Dengue hemorrhagic fever in children in Bandung, Indonesia.Annales de la Societe Belge de Medecine Tropicale 1995; 75 (4): 291–295.

    PubMed  CAS  Google Scholar 

  9. Sarala R, Mukundan D. Neurological manifestations in Dengue Hemorrhagic fever.Indian Pediatr 1994; 31: 688–690.

    Google Scholar 

  10. Kabra SK, Jain Y, Singhal T, Ratageri VH. Dengue Hemorrhagic fever: Clinical manifestations and management.Indian J Pediatr 1999; 66: 93–101.

    PubMed  CAS  Google Scholar 

  11. McGready R, Paw E, Nosten F. Menorrhagia caused by Dengue fever.Australian New Zealand J Obstetrics Gynaecology 2000; 40 (3): 345–355.

    Google Scholar 

  12. Agarwal R, Kapoor S, Nagar R, Misra A, Tandon R, Mathur Aet al. A clinical study of the patients with dengue hemorrhagic fever during the epidemic of 1996 at Lucknow, India.South East Asian J Tropical Medicine Public Health 1999; 30 (4): 735–740.

    CAS  Google Scholar 

  13. Chuansumrit A, Phimolthares V, Tardtong P, Tapaneya-Olarn C, Tapaneya-Olarn W, Kowsathit Pet al. Transfusion requirements in patients with dengue hemorrhagic fever.South East Asian I Tropical Medicine Public Health 2000; 31 (1): 10–14.

    CAS  Google Scholar 

  14. Chua MN, Molanida R, de Guzman M, Laberiza F. Prothrombin time and partial thromboplastin time as a predictor of bleeding in patients with dengue Hemorrhagic fever.South East Asian J Tropical Medicine Public Health 1993; 24 (1): 141–143.

    Google Scholar 

  15. Kabra SK, Jain Y, Madhulika, Tripathi P, Singhal T, Broor Set al. Role of Platelet Transfusion in dengue hemorrhagic fever.Indian Pediatr 1998; 35:452–455.

    PubMed  CAS  Google Scholar 

  16. Kalayanarooj S, Vaughn DW, Nimmannitya S, Green S, Suntayakorn S, Kunentrasai Net al. Early clinical and laboratory indicators of acute dengue illness.J Infectious Dis 1997; 176 (2): 313–321.

    Article  CAS  Google Scholar 

  17. Kuo CH, Tai Di, Chang-Chien CS, Lan CK, Chiou SS, Liaw YF. Liver biochemical tests and dengue fever.Am J Tropical Medicine Hygiene 1992; 47 (3): 265–270.

    CAS  Google Scholar 

  18. Wahid SF, Sanusi S, Zawawi MM, Ali RA. A comparison of the pattern of liver involvement in dengue hemorrhagic fever with classical dengue fever.South East Asian J Tropical Medicine Public Health 2000; 31(2): 259–263.

    CAS  Google Scholar 

  19. Nguyen TL, Nguyen TH, Tieu NT.Res Virol 1997; 148 (4): 273–277.

    Article  PubMed  CAS  Google Scholar 

  20. Lucas GN, Amerasinghe A, Sriranganathan S. Dengue hemorrhagic fever in Sri Lanka.Indian J Pediatr 200; 67 (7): 503–504.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to So. Shivbalan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shivbalan, S., Anandnathan, K., Balasubramanian, S. et al. Predictors of spontaneous bleeding in Dengue. Indian J Pediatr 71, 33–36 (2004). https://doi.org/10.1007/BF02725653

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02725653

Key words

Navigation