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Atypical lymphocyte count correlates with the severity of dengue infection

INTRODUCTION: The early identification of patients at risk of severe dengue infection (DI) is critical to guide clinical management. There is currently no validated laboratory test which can predict severe complications of DI. The Atypical lymphocyte count (ALC) is a research parameter generated at...

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Autores principales: Clarice, Choong Shi Hui, Abeysuriya, Visula, de Mel, Sanjay, Uvindu Thilakawardana, Basuru, de Mel, Primesh, de Mel, Chandima, Chandrasena, Lal, Seneviratne, Suranjith L., Yip, Christina, Yap, Eng Soo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6494037/
https://www.ncbi.nlm.nih.gov/pubmed/31042724
http://dx.doi.org/10.1371/journal.pone.0215061
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author Clarice, Choong Shi Hui
Abeysuriya, Visula
de Mel, Sanjay
Uvindu Thilakawardana, Basuru
de Mel, Primesh
de Mel, Chandima
Chandrasena, Lal
Seneviratne, Suranjith L.
Yip, Christina
Yap, Eng Soo
author_facet Clarice, Choong Shi Hui
Abeysuriya, Visula
de Mel, Sanjay
Uvindu Thilakawardana, Basuru
de Mel, Primesh
de Mel, Chandima
Chandrasena, Lal
Seneviratne, Suranjith L.
Yip, Christina
Yap, Eng Soo
author_sort Clarice, Choong Shi Hui
collection PubMed
description INTRODUCTION: The early identification of patients at risk of severe dengue infection (DI) is critical to guide clinical management. There is currently no validated laboratory test which can predict severe complications of DI. The Atypical lymphocyte count (ALC) is a research parameter generated at no extra cost when an automated Full Blood Count (FBC) is performed. The purpose of this study was to assess the association of ALC with the severity of DI. METHODS: We prospectively collected data on patients admitted to Nawaloka Hospital Sri Lanka (NH) with DI between December 2016 and November 2017. DI was diagnosed based on a positive Non-structural antigen 1 (NS1) or dengue IgM antibody. ALC (absolute ALC and percentage) data were extracted from the Sysmex XS500i automated full blood count (FBC) analyzer (Sysmex Corporation Kobe, Japan). Clinical data was recorded from medical records and the computerized data base maintained by NH. RESULTS: 530 patients were enrolled. Patients with clinical manifestations of severe dengue have a significantly higher AL % compared to dengue without warning signs. Patients who presented with respiratory compromise had statistically significantly higher AL% compared to those without. (AL%; 8.65±12.09 vs 2.17±4.25 [p = 0.01]). Similarly, patients who developed hypotension had higher AL% compared to those who did not suffered from shock (AL%; 8.40±1.26 vs 2.18±4.25 [p = 0.001]). The AL% of dengue patients presenting with bleeding, at 4.07%, is also higher than those without bleeding complications, at 2.15%. There was a significant negative association between platelet count and AL% (p = 0.04). CONCLUSIONS: Clinical manifestations of severe dengue have a significantly higher AL % compared to dengue without warning signs. AL % at presentation may be predictive of severe DI and future larger prospective longitudinal studies should be done to determine if AL % on admission is predictive of the complications of DI.
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spelling pubmed-64940372019-05-17 Atypical lymphocyte count correlates with the severity of dengue infection Clarice, Choong Shi Hui Abeysuriya, Visula de Mel, Sanjay Uvindu Thilakawardana, Basuru de Mel, Primesh de Mel, Chandima Chandrasena, Lal Seneviratne, Suranjith L. Yip, Christina Yap, Eng Soo PLoS One Research Article INTRODUCTION: The early identification of patients at risk of severe dengue infection (DI) is critical to guide clinical management. There is currently no validated laboratory test which can predict severe complications of DI. The Atypical lymphocyte count (ALC) is a research parameter generated at no extra cost when an automated Full Blood Count (FBC) is performed. The purpose of this study was to assess the association of ALC with the severity of DI. METHODS: We prospectively collected data on patients admitted to Nawaloka Hospital Sri Lanka (NH) with DI between December 2016 and November 2017. DI was diagnosed based on a positive Non-structural antigen 1 (NS1) or dengue IgM antibody. ALC (absolute ALC and percentage) data were extracted from the Sysmex XS500i automated full blood count (FBC) analyzer (Sysmex Corporation Kobe, Japan). Clinical data was recorded from medical records and the computerized data base maintained by NH. RESULTS: 530 patients were enrolled. Patients with clinical manifestations of severe dengue have a significantly higher AL % compared to dengue without warning signs. Patients who presented with respiratory compromise had statistically significantly higher AL% compared to those without. (AL%; 8.65±12.09 vs 2.17±4.25 [p = 0.01]). Similarly, patients who developed hypotension had higher AL% compared to those who did not suffered from shock (AL%; 8.40±1.26 vs 2.18±4.25 [p = 0.001]). The AL% of dengue patients presenting with bleeding, at 4.07%, is also higher than those without bleeding complications, at 2.15%. There was a significant negative association between platelet count and AL% (p = 0.04). CONCLUSIONS: Clinical manifestations of severe dengue have a significantly higher AL % compared to dengue without warning signs. AL % at presentation may be predictive of severe DI and future larger prospective longitudinal studies should be done to determine if AL % on admission is predictive of the complications of DI. Public Library of Science 2019-05-01 /pmc/articles/PMC6494037/ /pubmed/31042724 http://dx.doi.org/10.1371/journal.pone.0215061 Text en © 2019 Clarice et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Clarice, Choong Shi Hui
Abeysuriya, Visula
de Mel, Sanjay
Uvindu Thilakawardana, Basuru
de Mel, Primesh
de Mel, Chandima
Chandrasena, Lal
Seneviratne, Suranjith L.
Yip, Christina
Yap, Eng Soo
Atypical lymphocyte count correlates with the severity of dengue infection
title Atypical lymphocyte count correlates with the severity of dengue infection
title_full Atypical lymphocyte count correlates with the severity of dengue infection
title_fullStr Atypical lymphocyte count correlates with the severity of dengue infection
title_full_unstemmed Atypical lymphocyte count correlates with the severity of dengue infection
title_short Atypical lymphocyte count correlates with the severity of dengue infection
title_sort atypical lymphocyte count correlates with the severity of dengue infection
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6494037/
https://www.ncbi.nlm.nih.gov/pubmed/31042724
http://dx.doi.org/10.1371/journal.pone.0215061
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