DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20213725

Thrombocytosis: a predictor of severity in children with lower respiratory tract infection

Chandrakala P., Vinutha Patil, Kavya V. N., Sushmitha .

Abstract


Background: Community acquired pneumonia remains a significant cause of morbidity and mortality due to infection all over the world. Thrombocytes are known to be an essential part of immune response to various infectious agents. Platelet count elevated more than normal is often sign of severe pneumonia according to various studies.

Methods: This is a retrospective study conducted in Kempegowda Institute of Medical Science, a tertiary care hospital in Bangalore with a study duration of 1 year. All children were classified into two groups based on platelet count that is with thrombocytosis and without thrombocytosis. Respiratory distress was defined as presence of tachypnoea, chest retractions, oxygen saturation <94% in room air. Children with respiratory distress were classified as severe pneumonia and those with no respiratory distress as non-severe pneumonia.

Results: A total of 213 children were admitted with lower respiratory tract infection of which 35 children were excluded based on exclusion criteria. Of these 178 children 142 (80%) belonged to non-severe pneumonia group and 36 (20%) belonged to severe pneumonia group. Thrombocytosis is found in 31 (17%) children, 147 (82%) children had platelet count less than 4.5 lakhs/cu mm. Of these children with thrombocytosis 13 (42%) had non severe pneumonia and 18 (58%) had severe pneumonia. The p<0.0000001 which showed statistical significance, that is thrombocytosis was significantly associated with severity of pneumonia.

Conclusions: Thrombocytosis can be considered as a marker of severity of pneumonia in day-to-day practice.


Keywords


Severe pneumonia, Non-severe pneumonia, Thrombocytosis, Respiratory distress

Full Text:

PDF

References


The global health observatory by WHO. Available at: https://www.who.int/data/gho. Accessed on 02 May 2021.

Katz, Kolappa, Becker RC. Beyond thrombosis: the versatile platelet in critical illness. chest. 2011;139:658-68.

Elzey BD, Sprague DL, Ratliff TL. The emerging role of platelets in adaptive immunity. Celimmunol. 2005;238:1-9.

Stokes KY, Granger DN. Platelets: a critical link between inflammation and microvascular dysfunction. J Physiol. 2011;590(5):1023-34.

Chen Y, Zhong H. Role of platelet biomarkers in inflammatory response. Biomarker Res. 2020;28.

Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC et al. Infectious Disease Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007;44:S27-72.

Chaudhary J. Thrombocytosis in under five children with lower respiratory tract infection. Arch Pediatric Infect Dis. 2017;6(1);e61605.

Normal respiratory rate in kids and adults by Eleesha Lockett. 2009. Available at: https://www. healthline.com/health/normal-respiratory-rate. Accessed on 02 May 2021.

Platelet count as predictor of outcome of hospitalized patients with pneumonia at zagazig university, Egypt. Egyptian J Bronchol. 2020;11.

Yohannan MD, Higgy KE, Al-Mashhadani SA, Santhosh-Kumar CR. Thrombocytosis. Etiologic analysis of 663 patients. Clin Paediatric (Philia). 1994;33:340-3.

Vlacha V, Feketea G. Thrombocytosis in paediatric patients is associated with severe lower respiratory tract inflammation. Arch Med Res. 2006;37:755-9.

Prince E. Thrombocytosis is a marker of poor outcome in community acquired pneumonia. Chest. 2013;11.

Wolach B. Thrombocytosis after pneumonia with empyema and other bacterial infections in children. 1990;9(10):718-21.