Monocytosis and Hypogranulation of Neutrophils as an early predictor of Dengue Infection

Abstract

Dengue infection is a major public health problem, affecting general population in the south East Asia region. The hematologic aberration including relative lymphocytosis, coagulopathy and predominant thrombocytopenia are common in patients with dengue infection Complete blood count is an important part of the diagnostic work up of patients. Comparison of various findings in CBC which come with no extra cost can help the physician in an earlier diagnosis.

Materials and Methods: This observational study was carried out on a series of suspected dengue patients seen in the General Medicine unit of jubilee Mission Medical College in 2014. Based on the serology result, the patients with clinical suspicion of dengue was divided into dengue negative but febrile and dengue positive. A group of normal control was also simultaneously run which included samples of blood donors.

The various CBC parameters were studied in different groups. We used the VCS technology of the Beckmann counter automated analyzer to quantify the morphological characteristics of leukocytes like cell volume and granularity.

Results: There was marked Monocytosis in the dengue positive patients in comparison with the febrile control and normal control. Monocyte anisocytosis was seen in dengue positive cases reflected by Mean monocyte SD volume. We also found statistically significant changes in the neutrophil scatter for dengue positive cases like hypo granulation of neutrophils.

Conclusion: Leukopenia and thrombocytopenia are the usual indicators of dengue. But in their absence serological testing and diagnosis is delayed. In this study it is seen that monocyte volume and count is increased even in those dengue infected patients with unremarkable hematological profile which thus can be an early predictor of the disease.