The Role of Thrombocytopenia in Dengue: Marker of Progression vs. Predictor of Severity

Background: Dengue fever, a mosquito-borne viral disease poses significant public health challenges globally. Objective: To investigate the clinical manifestations, laboratory findings and observed the outcomes in dengue patients with thrombocytopenia. Methods: This observational study was conducted at 500 bedded Kurmitola General Hospital, Dhaka over six months, involving 1000 female patients diagnosed with dengue fever. Data on clinical symptoms, laboratory parameters and patient outcomes were collected and analyzed. Results: All patients exhibited fever, with other common symptoms including loose motion (43.2%), vomiting (42.9%) and abdominal pain (37.9%). Laboratory findings showed significant thrombocytopenia and elevated liver enzymes, while renal function remained normal. Notably, there was a 1.9% mortality rate, interestingly all cases of mortality observed in patients with normal platelets count, and 100% patients with thrombocytopenia recovering, challenging the traditional view of thrombocytopenia as a negative prognostic indicator in dengue fever. Conclusion: The study highlights a high recovery rate in patients with thrombocytopenia. However, the significant incidence of plasma leakage with normal platelet count was associated with increased mortality, contradicting previous assumptions about its prognostic value. JAFMC Bangladesh, Vol-22, No-1, June 2026: 72-75