Please use this identifier to cite or link to this item: https://doi.org/10.1371/journal.pone.0215061
Title: Atypical lymphocyte count correlates with the severity of dengue infection
Authors: Clarice, Choong Shi Hui
Abeysuriya, Visula
de Mel, Sanjay
Thilakawardana, Basuru Uvindu
de Mel, Primesh
de Mel, Chandima
Chandrasena, Lal
Seneviratne, Suranjith L
Yip, Christina
Yap, Eng Soo 
Keywords: Science & Technology
Multidisciplinary Sciences
Science & Technology - Other Topics
CLASSIFICATION
Issue Date: 1-May-2019
Publisher: PUBLIC LIBRARY SCIENCE
Citation: Clarice, Choong Shi Hui, Abeysuriya, Visula, de Mel, Sanjay, Thilakawardana, Basuru Uvindu, de Mel, Primesh, de Mel, Chandima, Chandrasena, Lal, Seneviratne, Suranjith L, Yip, Christina, Yap, Eng Soo (2019-05-01). Atypical lymphocyte count correlates with the severity of dengue infection. PLOS ONE 14 (5). ScholarBank@NUS Repository. https://doi.org/10.1371/journal.pone.0215061
Abstract: 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.
Source Title: PLOS ONE
URI: https://scholarbank.nus.edu.sg/handle/10635/237843
ISSN: 1932-6203,1932-6203
DOI: 10.1371/journal.pone.0215061
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