Role of mean platelet volume and platelet distribution width in assessing the severity of dengue fever: An observational study

Background: Platelet count has been widely used to evaluate the severity, guide management and predict outcome in patients with dengue fever. This sole use, however, has prevented the utility of other platelet indices like Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) from being explored. Objectives: To study the association of MPV and PDW with the disease severity in patients with dengue fever. Materials and Methods: This prospective observational study was conducted in a tertiary care centre of Northern India for a period of one year. A total of 100 patients with confirmed dengue infection who fulfilled the inclusion criteria were followed from the day of admission to recovery. Clinical and laboratory findings, including platelet parameters were noted. They were classified on the basis of World Health Organization (WHO) 2009 criteria, and MPV and PDW values were correlated in each category. Pearson correlation analysis was performed for correlation identification between platelet indices and disease severity. Results: 64% patients with dengue fever had a low MPV (<9.0 fl). An increased PDW (>13 fl) was observed in 77% cases. A significant correlation was observed between low MPV and platelet count in severe dengue (P value <0.01). Strongest correlation was observed between low MPV and severe dengue (r value 0.745). No significant correlation was witnessed between PDW and severity of infection. Conclusion: Mean platelet volume may serve as an additional laboratory marker to predict severe dengue infection, but PDW is inferior in delineating the disease severity.