Trends in Presentation and Clinical Phenotyping of Febrile Thrombocytopenia at a Tertiary Care Center in Bengaluru, India

Abstract

Background: Febrile thrombocytopenia is encountered with varying etiologies in daily clinical practice. However, these presentations vary within each disease in different seasons and may vary across various years. Objective: The aim of this study was to evaluate the changing trends in presentation of febrile thrombocytopenia and organize into clusters based on clinical phenotypes. Methodology: Clinicolaboratory data were extracted from case records from the medical records department and entered in a predesigned pro forma. Cases of febrile thrombocytopenia aged above 18 years, from January 2014 to October 2019 were included based on systematic random sampling. Subjects were grouped based on a 2-step cluster analysis. Results: Of the 352 patients, myalgia (52.3%), headache (41.2%), and nausea/vomiting (34.4%) were the most prevalent symptoms. Across the years, myalgia, headache, nausea/vomiting, splenomegaly, hepatosplenomegaly, ascites, and ocular pain showed a statistically significant increase in occurrence. Leukopenia and monocytosis were observed to have a significant linear increasing trend in frequency over the years. Cluster analysis showed significant mortality in cluster 3. Conclusion: Clinical and laboratory parameters provide a substantial clue to the early diagnosis of febrile thrombocytopenia which results from many different etiological factors. Monocytosis was strongly associated with dengue. Cluster analysis helps in better management and prevention of complications in severe cases.

Keywords

• blood platelets
• dengue
• fever
• malaria
• platelet count
• thrombocytopenia