Differential Leukocyte and Platelet Counts as Early Diagnostic Indicators in Acute Dengue Infection

  • Alishba Naeem
  • Maryam Zahra
  • Sehar Khaliq foundation university medical college rawalpindi
Keywords: Acute dengue, differential leukocyte count, platelets count, thrombocytopenia, neutropenia


Introduction: Dengue is an epidemic in Pakistan. Proper monitoring of dengue cases is necessary for its early diagnosis and prevention, especially in developing countries with limited resources. Our study aims to use some hematological parameters as Early Diagnostic Indicators in Acute Dengue Infection which can help reduce mortality and morbidity.

Materials and Methods: Dengue NS1 Antigen test was used to identify 119 Dengue Patients over August-October, 2019. Hematological data from such patients was collected and analysed.

Results:  In our study thrombocytopenia was prominent with sensitivity based on gender distribution being 86% for males and 76% for females. According to age, distribution thrombocytopenia had a sensitivity of up to 81% in the younger age group and 80% in the older age group.

The other prominent findings in younger age groups were lymphopenia, neutropenia, and monocytopenia with a sensitivity of 55%, 43%, and 24% respectively. Lymphopenia and neutropenia had similar sensitivity across the two genders, whereas monocytopenia had higher sensitivity among females of 27% as opposed to males of 12%.

Eosinopenia did not differ as much among the two age groups i.e. 18% in young and 19% in older patients and across the two genders i.e. 56% in males and 60% in females.

The sensitivity of lymphocytosis in older patients is 21% which was also significant.

Conclusions:  The Differential Leukocyte Count and Platelets Count can help as an early indicator of acute dengue infection in resource-limited areas. This can help in early diagnosis and prompt treatment thus reducing complications.


1. https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue
2. Haider Z, Ahmad FZ, Mahmood A, Waseem T, Shafiq I, Raza T, et al. Dengue fever in Pakistan: a paradigm shift; changing epidemiology and clinical patterns. Perspect Public Health. 2015 Nov;135(6):294-8. doi: 10.1177/1757913915599019. Epub 2015 Sep 4. PMID: 26342006.
3. Gubler DJ. Dengue and dengue hemorrhagic fever. Clinical microbiology reviews. 1998;11(3): 480–496.
4. Rasheed SB, Butlin RK, Boots M. A review of dengue as an emerging disease in Pakistan. Public Health. 2013 Jan;127(1):11-7. doi: 10.1016/j.puhe.2012.09.006. Epub 2012 Dec 6. PMID: 23219263.
5. Khan J, Khan I, Ghaffar A, Khalid B. Epidemiological trends and risk factors associated with dengue disease in Pakistan (1980-2014): a systematic literature search and analysis. BMC Public Health. 2018 Jun 15;18(1):745. doi: 10.1186/s12889-018-5676-2. PMID: 29907109; PMCID: PMC6003098.
6. Sirisena PD, Noordeen F. Evolution of dengue in Sri Lanka-changes in the virus, vector, and climate. Int J Infect Dis. 2014 Feb;19:6-12. doi: 10.1016/j.ijid.2013.10.012. Epub 2013 Dec 11. PMID: 24334026.
7. Ralapanawa, U., Alawattegama, A., Gunrathne, M., Tennakoon, S., Kularatne, S., & Jayalath, T. (2018). Value of peripheral blood count for dengue severity prediction. BMC research notes, 11(1), 400. https://doi.org/10.1186/s13104-018-3505-4
8. Ali A, Ahmad H, Idrees M, Zahir F, Ali I. Circulating serotypes of dengue virus and their incursion into non-endemic areas of Pakistan; a serious threat. Virol J. 2016 Aug 26;13(1):144. doi: 10.1186/s12985-016-0603-6. PMID: 27565893; PMCID: PMC5002134.
9. Sharma SN, Raina VK, Kumar A. Dengue/DHF: an emerging disease in India. J Commun Dis. 2000 Sep;32(3):175-9. PMID: 11407002.
10. Joshi A, Gayathri B., Fazeela M. Dynamics of differential count in dengue. International Journal of Advances in Medicine. 2018 Jan; 5(1): 145-150
11. Munde DD, Shetkar UB, Clinical Features And Hematological Profile of Dengue Fever, Indian Journal Of Applied Research; Jan 2013; 3(1): 131-132.
12. Gajera VV, Sahu S, Dhar R. Study of haematological profile of Dengue Fever and its clinical implication. Annals of Applied Bio-Sciences. 2016;3(3):241-6.
13. Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control: New Edition. Geneva: World Health Organization; 2009. 4, LABORATORY DIAGNOSIS AND DIAGNOSTIC TESTS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK143156/
14. Ali N, Usman M, Syed N, Khurshid M. Haemorrhagic manifestations and utility of haematological parameters in dengue fever: A tertiary care centre experience at Karachi. Scandinavian J Infect Dis. 2007;39(11-12):1025-8.
15. Patel K, Patel D, Das VK. Hematological Parameters and Its Utility in Dengue Fever: A Prospective Study. Internat J of Sci Res. 2016;5(4):1077-9.
16. Jameel T, Mehmood K, Mujtaba G, Choudhry N, Afzal N, Paul R.F Changing haematological parameters in dengue viral infection J Ayub Med Coll Abb ottabad. 2012;24(1):3

17. Thein T, Wong J, Lye D, Hao Y, Wilder-Smith A, Leo Y. Severe Neutropenia in Dengue Patients: Prevalence and Significance. The American Journal of Tropical Medicine and Hygiene. 2014;90(6):984- 7.
18. Thanh HN, Huan-Yao L, Trong LN, Yee-Shin L, Kao-Jean H, Bich LL, et al. Dengue hemorrhagic fever in infants: A study of clinical and cytokine profiles. The Journal of Infectious Diseases. 2004;189(2):221-32.
19. Benachinmardi KK, Panduranga C, Srinivasamurthy V, Burugina SN, Vani BR, Navaneeth BV. Hematological Profile in Acute Dengue infectioin- A study at Tertiary Care Teaching Hospital. J Pharmaceutic Biomedic Sci. 2013;36:1866-70. 

20. 20. Qiu FX, Gubler DJ, Liu JC, Chen QQ. Dengue in China a clinical review. Bulletin of the World Health Organization.1993; 71(3/4):349-59
21. Beeson, PB, DA Bass. The eosinophile, In Smith LH. (ed.), Major problems in internal medicine, Vol. 14. Philadelphia. WB Saunders Co. 1977;215-34.
22. Khatri K, Rajani A, Khalla AR. Plasmacytoid lymphocytes: a diagnostic clue to dengue infection. Int J Sci Res. 2016;5(3):1002-5.
22. 23. Achalkar G. Dengue: A Clinico-Pathological Study Of 50 Cases. J Evolut Medic Dental Sci. 2013;2(48):9380-5.
23. 24. Mehta RC, Goswami HM, Katara RK, Patel PS, Parikh UV, Vegad MM, et al. Importance of Complete Blood Count and Peripheral Smear Examination In Early Diagnosis Of Dengue Patients. J Infects Dis Letters. 2013;2(1):22-4.
24. 29. John DV, Lin YS, Perng GC. Biomarkers of severe dengue disease-a review. J Biomedic Sci. 2015;22:83:1-7
How to Cite
Naeem A, Zahra M, Khaliq S. Differential Leukocyte and Platelet Counts as Early Diagnostic Indicators in Acute Dengue Infection. JRMC [Internet]. 30Jun.2022 [cited 24Sep.2022];26(2):225-30. Available from: http://www.journalrmc.com/index.php/JRMC/article/view/1793