Prophylactic platelet transfusion does not reduce risk of clinical bleeding in adults with dengue and thrombocytopaenia.

Commentary on: Lye DC, Archuleta S, Syed-Omar SF, et al . Prophylactic platelet transfusion plus supportive care versus supportive care alone in adults with dengue and thrombocytopenia: a multicentre, open-label, randomised, superiority trial. Lancet 2017;389:1611–18. Dengue is the fastest growing vector-borne viral disease worldwide afflicting nearly 390 million people in 2010 with 96 million having clinically apparent infection.1 The clinical spectrum of dengue infection can vary from asymptomatic infection to life-threatening dengue shock syndrome.2 3 Thrombocytopaenia is a common manifestation of dengue infection. However, a correlation between platelet count and risk of clinical bleeding in dengue has not been established. A number of observational studies4 and a small randomised trial5 have shown lack of effectiveness of prophylactic platelet transfusion in preventing clinical bleeding in adults with dengue and thrombocytopaenia. This larger …