Platelet Transfusion and Tranexamic Acid in the Treatment of Bleeding in Dengue Fever

Objective: We conducted this study to investigate the effectiveness of platelet transfusion and/or intravenous tranexamic acid in the treatment of clinical bleeding in patients with dengue fever at a tertiary care hospital during a large outbreak (August and November, 2011) of dengue fever in Lahore, Pakistan.

Methods: We reviewed data of patients with clinical bleeding and confirmed dengue fever at Jinnah Hospital Lahore, Pakistan. Based on the treatment, patients were classified into four groups: Baseline characteristics of patients and site and grade of bleeding were documented. A comparison of time to cessation of bleeding across four groups was made.

Results: Out of 100 selected patients with clinical bleeding, 65 were male and median age was 28 years (range 13-80). There were 47 patients in group A, 12 in group B, 9 in group C, and 32 in group D. 75 patients had bleeding from a single site while 24 patients had bleeding from 2 different sites and 1 patient had bleeding from 3 sites. Median time from the initiation of treatment till the cessation of bleeding was not significantly difference across four groups (p value = 0.724, Kruskal-Wallis test). Adverse effects included abdominal pain in group A and pruritus in group A and C.

Conclusion: Platelet transfusion and/or tranexamic acid do not provide significant benefit over standard of care treatment in patients with clinical bleeding in dengue fever and may be associated with adverse outcome.