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Point-of-care thrombocyte function testing using multiple-electrode aggregometry in dengue patients: an explorative
Wesley de Jong1, Tri Pudy Asmarawati2, Inge Verbeek3
1Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands. w.dejong.2@erasmusmc.nl.
BMC Infectious Diseases
|August 9, 2020
Summary
Quantitative thrombocyte function tests show impaired platelet aggregation in dengue virus (DENV) patients. This finding could help identify severe cases early for better patient triage and management.
Area of Science:
- Medical Research
- Infectious Diseases
- Hematology
Background:
- Dengue virus (DENV) infections cause significant global morbidity, with 500,000 hospitalizations annually.
- Distinguishing severe DENV cases requiring hospitalization from milder ones is challenging, particularly in resource-limited settings.
- Thrombocyte count and function are recognized as potential indicators of DENV severity.
Purpose of the Study:
- To investigate the utility of quantitative thrombocyte function tests in the early stages of acute DENV infection.
- To explore the potential of multiplate™ multiple-electrode aggregometry for patient triage in DENV cases.
Main Methods:
- A prospective cohort study included patients aged ≥13 with suspected DENV admitted to Universitas Airlangga Hospital.
- Exclusion criteria included low thrombocyte count (<100×10⁹/L) and use of anticoagulant or anti-inflammatory medications.
- Platelet aggregation was measured using ADP-, TRAP-, and COL-tests, presented as Area Under the aggregation Curve (AUC), and compared between DENV-positive, probable DENV, other fever causes, and healthy controls.
Main Results:
- Significantly lower thrombocyte aggregation was observed in the DENV-positive group compared to healthy controls and other fever causes (p < .001).
- Low Adenosine diphosphate (ADP) AUC values at baseline correlated with longer hospital stays in DENV-positive and probable DENV cases.
- The study included 59 patients (10 DENV+, 25 probable DENV, 24 other fever) and 20 healthy controls.
Conclusions:
- Thrombocyte aggregation induced by ADP, Collagen, and Thrombin receptor activating peptide-6 is impaired in dengue virus infections.
- These findings suggest that quantitative thrombocyte function tests may serve as a valuable future biomarker for DENV disease severity and patient triage.
