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Published on: April 28, 2019
Corticosteroid responsive prolonged thrombocytopenia in a case of dengue fever
Shailendra Prasad Verma1, Abdoul Hamide, Jyoti Wadhwa
1Division of Clinical Haematology, Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research JIPMER, Pondicherry, India. drspkgmu@rediffmail.com
Thrombocytopenia and bleeding manifestations are consistent features of dengue fever. Usually thrombocytopenia resolves and platelet count normalises by day 10 of fever. Persistent thrombocytopenia is not a feature of dengue fever. Proposed mechanisms behind thrombocytopenia are many. Direct platelet destruction by dengue virus, immune-mediated platelet destruction and even megakaryocytic immune injury have been proposed as underlying mechanisms. We are reporting a case of an old man who presented in dengue season in 2012 with fever and bleeding and was diagnosed as a case of dengue fever. He developed persistent thrombocytopenia requiring treatment on the lines of immune thrombocytopenia and responded to steroids. Other causes of thrombocytopenia were ruled out.
Thrombocytopenia and bleeding manifestations are consistent features of dengue fever. Usually thrombocytopenia resolves and platelet count normalises by day 10 of fever. Persistent thrombocytopenia is not a feature of dengue fever. Proposed mechanisms behind thrombocytopenia are many. Direct platelet destruction by dengue virus, immune-mediated platelet destruction and even megakaryocytic immune injury have been proposed as underlying mechanisms. We are reporting a case of an old man who presented in dengue season in 2012 with fever and bleeding and was diagnosed as a case of dengue fever. He developed persistent thrombocytopenia requiring treatment on the lines of immune thrombocytopenia and responded to steroids. Other causes of thrombocytopenia were ruled out.
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