Rebound thrombocytosis and persistence of clinical symptoms after recovery from dengue hemorrhagic fever

How to cite this article:
Sriwijitralai W, Wiwanitkit V. Rebound thrombocytosis and persistence of clinical symptoms after recovery from dengue hemorrhagic fever. Ann Trop Med Public Health 2017;10:286

 

How to cite this URL:
Sriwijitralai W, Wiwanitkit V. Rebound thrombocytosis and persistence of clinical symptoms after recovery from dengue hemorrhagic fever. Ann Trop Med Public Health [serial online] 2017 [cited 2017 Jul 15];10:286. Available from: https://www.atmph.org/text.asp?2017/10/1/286/205577

Dear Sir,

The clinical problems of dengue include an acute febrile illness and decreasing platelet count.[1] The management of the patient is by having a good fluid replacement therapy until the recovery of platelet count.[1] Nevertheless, sometimes, there can be problematic situations after the complete recovery of platelet count. Here, the authors present an exemplary case of rebound thrombocytosis and persistence of clinical symptoms after recovery from dengue hemorrhagic fever. The patient is a 19-year-old female. The patient was just diagnosed of dengue hemorrhagic fever 10 days before and had fluid replacement therapy until the recovery of platelet count (platelet count at first diagnosis of dengue = 50,000/μL; at recovery – Day 7th = 190,000/μL). However, this case still had the problem of myalgia and arthralgia, hence, returned to the physician. Repeated examination showed platelet count equal to 500,000/μL. This case was closely followed up for another 1 week, and the platelet count returned to normal (200,000/μL) but the myalgia and arthralgia problem still existed. This case is an example of rebound thrombocytosis.[2],[3] It is not commonly documented and it can result in poor outcome such as myocardial infarction.[2] In addition, in the present case, the persistence of clinical symptoms is also observed. This is also a less mentioned issue in postdengue care. According to the study by García et al., dengue symptoms can last upto 2 years.[4] Follow up is recommended for those cases.

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Conflicts of interest

There are no conflicts of interest.

References

 

1.
Wiwanitkit V. Dengue fever: Diagnosis and treatment. Expert Rev Anti Infect Ther 2010;8:841-5.
2.
A R, R Y, B B, Kc G. Rebound thrombocytosis causing MI following dengue fever? Indian Heart J 2007;59:94.
3.
Trung DT, Thao le TT, Dung NM, Ngoc TV, Hien TT, Chau NV, et al. Clinical features of dengue in a large Vietnamese cohort: Intrinsically lower platelet counts and greater risk for bleeding in adults than children. PLoS Negl Trop Dis 2012;6:e1679.
4.
García G, Gonzílez N, Pérez AB, Sierra B, Aguirre E, Rizo D, et al. Long-term persistence of clinical symptoms in dengue-infected persons and its association with immunological disorders. Int J Infect Dis 2011;15:e38-43.

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/1755-6783.205577

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