Effect of prednisolone during defervescence in dengue haemorrhagic fever: an open label controlled study

Abstract

Introduction: Immune-mediated destruction of platelets is thought to be one mechanism of thrombocytopenia seen after the viraemic phase of dengue haemorrhagic fever (DHF). Steroids are effective in the treatment of idiopathic thrombocytopenic purpura (ITP) which has a similar pathogenesis.  
Objective: To evaluate the efficacy of prednisolone in the rate of resolution of thrombocytopenia and development of complications in patients recovering from DHF grade I and II  
Method: An open label controlled study was carried out among 35 patients taking inward treatment at Teaching Hospital, Kandy between 31/08/2006 and 02/06/2007. Treatment group received prednisolone 10 mg tds with omeprazole 20 mg bd in addition to standard treatment. Control group received standard care only.  
Results: There were 20 and 15 patients in treatment and control groups respectively. Control group had a mean rate of platelet rise significantly higher than that of treatment group. (58 × 10⁹ /L /day vs. 27 × 10⁹ /L /day; p = 0.05) No one developed predefined complications or adverse effects attributable to prednisolone.  
Conclusion: This preliminary study has several limitations such as small sample size and laboratory data obtained from multiple sources. Therefore, large scale double blinded randomized controlled studies are needed before making recommendations on using steroids in patients with dengue haemorrhagic fever.

doi: 10.4038/gmj.v13i1.888

Galle Medical Journal Vol.13(1) 2008 18-21