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CC BY-NC-ND 4.0 · J Lab Physicians 2021; 13(02): 156-161
DOI: 10.1055/s-0041-1730849
Original Article

Pseudobasophilia as a Screening Tool in Dengue: A Single Center Study

Kevin Manuel 
1   Department of Pathology, Pondicherry Institute of Medical Sciences, Kalapet, Puducherry, India
,
Marie Moses Ambroise
1   Department of Pathology, Pondicherry Institute of Medical Sciences, Kalapet, Puducherry, India
,
Anita Ramdas
1   Department of Pathology, Pondicherry Institute of Medical Sciences, Kalapet, Puducherry, India
,
Renu G'Boy Varghese
1   Department of Pathology, Pondicherry Institute of Medical Sciences, Kalapet, Puducherry, India
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Abstract

Objectives Proper serological testing for the definite diagnosis of dengue is costly and may not be easily available in a resource-limited setting. Hematological parameters can help in the early identification of dengue cases. This study aims to evaluate the occurrence and utility of pseudobasophilia in identifying dengue-affected patients.

Materials and Methods This retrospective cross-sectional study included 1,304 dengue cases confirmed by serology and 1,044 dengue serology negative acute febrile illness cases as controls. Complete blood count (CBC) values of the first EDTA (ethylenediamine tetraacetic acid) blood sample from automated hematology analyzers were reviewed. The hematological parameters in the dengue and control groups were compared and the variation of these parameters with the day of fever was also analyzed.

Statistical Analysis Mann-Whitney’s test, Kruskal-Wallis test, and Fisher’s exact test were used for statistical analysis. A p-value < 0.05 was considered statistically significant for all tests.

Results There was a statistically significant variation between dengue cases and controls for hematocrit, platelet count, mean platelet volume, total white blood cell count, and absolute basophil count. The dengue group had a higher hematocrit from day 2 to day 10, platelet count ≤ 100,000/µL from day 4 to day 9, higher mean platelet volume from day 2 to day 7, leucopenia from day 3 to day 5, and higher absolute basophil count from day 2 to day 10. Interestingly, pseudobasophilia was seen in 533 (40.87%) of dengue cases and only 3 (0.28%) of the controls. Pseudobasophilia was also observed to have an increasing trend to the day of fever.

Conclusion Pseudobasophilia along with other CBC parameters is useful and cost effective for the early identification of dengue. This can prompt early investigations and supportive treatment leading to improved clinical outcomes.

Keywords

dengue - fever - automated hematology - lymphocytes


Publication History

Article published online:
19 June 2021

© 2021. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Mørch K, Manoharan A, Chandy S. et al. Acute undifferentiated fever in India: a multicentre study of aetiology and diagnostic accuracy. BMC Infect Dis 2017; 17 (01) 665
    CrossrefPubMedGoogle Scholar
  • 2 World Health Organization. Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control: New Edition. Geneva: World Health Organization 2009
  • 3 Mutheneni SR, Morse AP, Caminade C, Upadhyayula SM. Dengue burden in India: recent trends and importance of climatic parameters. Emerg Microbes Infect 2017; 6 (08) e70
    PubMedGoogle Scholar
  • 4 Galli SJ, Metcalfe DD, Arber DA, Dvorak AM. Basophils, mast cells, and related disorders. In: Kaushansky K, Lichtman MA, Prchal JT, et al, eds. Williams Hematology. 9th ed. New York:. McGraw-Hill Education 2016; 971-972
    Google Scholar
  • 5 Muniraj F, Amritraj V, Soundararajan G. Autoanalyzer generated spurious basophilia in adolescents and adults. Int J Sci Stud 2015; 3 (04) 1-5
    Google Scholar
  • 6 Amundsen EK, Henriksson CE, Holthe MR, Urdal P. Is the blood basophil count sufficiently precise, accurate, and specific?: Three automated hematology instruments and flow cytometry compared. Am J Clin Pathol 2012; 137 (01) 86-92
    CrossrefPubMedGoogle Scholar
  • 7 Hur M, Lee YK, Lee KM, Kim HJ, Cho HI. Pseudobasophilia as an erroneous white blood cell differential count with a discrepancy between automated cell counters: report of two cases. Clin Lab Haematol 2004; 26 (04) 287-290
    CrossrefPubMedGoogle Scholar
  • 8 Gibbs G, Campbell G, Christie I. Pseudobasophilia and the Advia 120. Hematology 2009; 14 (03) 159-163
    CrossrefPubMedGoogle Scholar
  • 9 Pai S. Pseudobasophilia on the Sysmex-XE 2100: a useful screening tool for primary dengue infection in endemic area. Int J Lab Hematol 2012; 34: 25
    Google Scholar
  • 10 Malathesha MK, Ashwini HN. Hematological manifestations in dengue fever—an observation study. J Evol Med Dent Sci 2014; 3 (09) 2245-2250
    CrossrefGoogle Scholar
  • 11 Chaloemwong J, Tantiworawit A, Rattanathammethee T. et al. Useful clinical features and hematological parameters for the diagnosis of dengue infection in patients with acute febrile illness: a retrospective study. BMC Hematol 2018; 18: 20
    CrossrefPubMedGoogle Scholar
  • 12 Martina BE, Koraka P, Osterhaus AD. Dengue virus pathogenesis: an integrated view. Clin Microbiol Rev 2009; 22 (04) 564-581
    CrossrefPubMedGoogle Scholar
  • 13 Vogt MB, Lahon A, Arya RP, Spencer Clinton JL, Rico-Hesse R. Dengue viruses infect human megakaryocytes, with probable clinical consequences. PLoS Negl Trop Dis 2019; 13 (11) 0007837
    Google Scholar
  • 14 de Azeredo EL, Monteiro RQ, de-Oliveira Pinto LM. Thrombocytopenia in Dengue: Interrelationship between virus and the imbalance between coagulation and fibrinolysis and inflammatory mediators. Mediators Inflamm 2015; 2015: 313842
    PubMedGoogle Scholar
  • 15 Noisakran S, Onlamoon N, Hsiao HM. et al. Infection of bone marrow cells by dengue virus in vivo. Exp Hematol 2012; 40 (03) 250-259.e4
    CrossrefPubMedGoogle Scholar
  • 16 Chandrashekar V. Basophil differentials as a marker for atypical lymphocyte morphologic characteristics. Lab Med 2013; 44 (02) 133-135
    CrossrefGoogle Scholar
  • 17 Jácomo RH, Lozano VF, da Cunha Neto JG, Costa SS. What’s the meaning of basophilia in Sysmex XE-2100?. Arch Pathol Lab Med 2011; 135 (04) 415
    CrossrefPubMedGoogle Scholar