High Dose Corticosteroids - A Boon or Bane in Dengue Fever with Thrombocytopenia: A Case Control Study

Dengue infection is an important public health problem globally infecting about 50100 million individuals every year. The increased peripheral destruction of the antibody coated platelets has been strongly suspected as the possible mechanism for thrombocytopenia in Dengue Fever. Corticosteroids are highly effective anti-inflammatory agents, frequently employed as adjunctive therapy in disease states where the host immune response is thought to contribute significantly to disease pathogenesis This was a case control study about the effect of high dose corticosteroids on platelet count in dengue fever patients. The study was conducted on 80 patients with dengue NS1+ve with platelet count less than 1, 00, 000 cu/mm. The study group received intravenous dexamethasone 16 mg initially, followed by 8 mg every 8 hours, thereafter for 4days. The control Group received only IV fluids and antipyretics whenever necessary. From this study we found that there was no significant difference in trends of increasing platelet counts between the two groups. The hospital stay was similar in both the groups, without any mortality and none of them developed shock or were admitted to intensive care during the study period of five days. In view of these observations, we conclude that the empirical use of steroids may be avoided in dengue fever with thrombocytopenia as high dose dexamethasone lacks efficacy in increasing the platelet count in thrombocytopenic dengue patients. The drawback of our study was, it was not a double blind placebo controlled trial and there were less number of subjects and cases of DHF and DSS were not included