Two separate studies by haematologists in Delhi and Mumbai have suggested a new blood test that can improve treatment in severe cases of dengue.
The study said that looking at immature platelet fraction (IPF) test which measures young platelets rather than the absolute platelet count (which includes the young platelets) is a more reliable indicator of the severity of the disease.
The study by doctors from Sir Ganga Ram Hospital, Delhi, and P D Hinduja Hospital in Mumbai said that the IPF test can be added to the infection disease control protocols to improve the treatment outcome and avoid unnecessary platelet transfusion in patients with low platelet count. High risk category in dengue patients includes those with a platelet count of 20,000 and below, and platelet transfusion is part of the current treatment guidelines. However, unnecessary platelet transfusions can cause complications like post-transfusion acute lung injury and sepsis — a life-threatening condition in which the body’s response to infection injures its own tissues and organs.
The Delhi hospital tried the test on 18 patients who needed platelet transfusion and found that a third of them did not need it. Dr Jyoti Kotwal, head of haematology department at Sir Ganga Ram Hospital, said, “IPF results of all the patients showed that six of them had high results and so we held back the transfusions. Platelet count of the patients improved gradually and they recovered.” She added, “This means about 33% of the patients would have undergone transfusion unnecessarily.”
In Mumbai, a similar study carried out by a team of five doctors from P D Hinduja Hospital was published in International Journal of Laboratory Haematology. The study showed that IPF can indicate whether the platelet count in a dengue patient is improving, thus doing away with the need for a transfusion. Out of the 32 patients who took part in the study, about 84.3% patients showed recovery within 24 h after high IPF results, 93.75% of the patients showed recovery within 24–48 hours.
Dr Om Shrivastava, head of Infection Disease Cell at Jaslok Hospital said, “Doctors should consider IPF to avoid unnecessary platelet transfusions.” He has been instrumental in forming protocols for treatment of infectious diseases for the municipal corporation and the state.