FACTORS ASSOCIATED WITH THROMBOCYTOPENIA IN HUMAN LEPTOSPIROSIS
Background: This study was conducted to investigate factors associated with thrombocytopenia in a large cohort of patients with leptospirosis in an endemic area. Patients and Methods: This is a retrospective study including 374 consecutive patients with leptospirosis admitted to tertiary hospital...
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2014-08-01
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doaj-6fe5820270684d84990bf2b4bed7d7b12020-11-25T02:49:29ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062014-08-011FACTORS ASSOCIATED WITH THROMBOCYTOPENIA IN HUMAN LEPTOSPIROSISElizabeth De Francesco Daher0Geraldo B. Silva Junior1Charles O. Silveira2Felipe S. Falcão3Marília P. Alves4Jório A.A.A. Mota5Joyce B. Lima6Rosa M.S. Mota7Ana Patrícia F. Vieira8Alexandre B. Libório91Division of Nephrology, Department of Internal Medicine, School of Medicine, Federal University of Ceará. Fortaleza, Ceará, Brazil. 2Post-graduate Program in Medical Sciences, School of Medicine, Federal University of Ceará. Fortaleza, Ceará, Brazil.1Division of Nephrology, Department of Internal Medicine, School of Medicine, Federal University of Ceará. Fortaleza, Ceará, Brazil. 2Post-graduate Program in Medical Sciences, School of Medicine, Federal University of Ceará. Fortaleza, Ceará, Brazil. 3School of Medicine, Health Sciences Center, University of Fortaleza. Fortaleza, Ceará, Brazil.1Division of Nephrology, Department of Internal Medicine, School of Medicine, Federal University of Ceará. Fortaleza, Ceará, Brazil. 2Post-graduate Program in Medical Sciences, School of Medicine, Federal University of Ceará. Fortaleza, Ceará, Brazil.1Division of Nephrology, Department of Internal Medicine, School of Medicine, Federal University of Ceará. Fortaleza, Ceará, Brazil.1Division of Nephrology, Department of Internal Medicine, School of Medicine, Federal University of Ceará. Fortaleza, Ceará, Brazil.1Division of Nephrology, Department of Internal Medicine, School of Medicine, Federal University of Ceará. Fortaleza, Ceará, Brazil.1Division of Nephrology, Department of Internal Medicine, School of Medicine, Federal University of Ceará. Fortaleza, Ceará, Brazil.4Department of Statistics, Federal University of Ceará. Fortaleza, Ceará, Brazil.1Division of Nephrology, Department of Internal Medicine, School of Medicine, Federal University of Ceará. Fortaleza, Ceará, Brazil.1Division of Nephrology, Department of Internal Medicine, School of Medicine, Federal University of Ceará. Fortaleza, Ceará, Brazil. Background: This study was conducted to investigate factors associated with thrombocytopenia in a large cohort of patients with leptospirosis in an endemic area. Patients and Methods: This is a retrospective study including 374 consecutive patients with leptospirosis admitted to tertiary hospitals in Fortaleza, Brazil. All patients had diagnosis of leptospirosis, and acute kidney injury (AKI) was defined according to the RIFLE criteria. Thrombocytopenia was defined as platelets count lower than 100,000/mm3. Results: A total of 374 patients were included, with a mean age of 36.1±15.5 years, and 83.4% were male. Thrombocytopenia was present at hospital admission in 200 cases (53.5%) and developed during hospital stay in 150 cases (40.3%). Patients with thrombocytopenia had a higher frequency of dehydration (53% vs. 35.3%, p=0.001), epistaxis (5.7% vs. 0.8%, p=0.033), hematemesis (13% vs. 4.6%, p=0.006), myalgia (91.5% vs. 84.5%, p=0.038), hematuria (54.8% vs. 37.6%, p=0.011), metabolic acidosis (18% vs. 9.2%, p=0.016) and hypoalbuminemia (17.8% vs. 7.5%, p=0.005). Independent risk factors associated with thrombocytopenia during hospital stay were length of disease (OR: 1.2, p=0.001) and AKI (OR: 6.6, p=0.004). Mortality was not associated with thrombocytopenia at admission (12.5% vs. 12.6%, p=1.000) or during hospital stay (12.6% vs. 11.3%, p=0.748). Conclusions: Thrombocytopenia is a frequent complication in leptospirosis, which was present in more than half of patients at hospital admission. The length of disease and AKI are risk factors for thrombocytopenia. There was no significant association between thrombocytopenia and mortality. Advanced age and oliguria were independent risk factors for death. https://mjhid.org/index.php/mjhid/article/view/1752LeptospirosisThrombocytopeniaPlateletsAcute kidney injuryMortality. |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Elizabeth De Francesco Daher Geraldo B. Silva Junior Charles O. Silveira Felipe S. Falcão Marília P. Alves Jório A.A.A. Mota Joyce B. Lima Rosa M.S. Mota Ana Patrícia F. Vieira Alexandre B. Libório |
spellingShingle |
Elizabeth De Francesco Daher Geraldo B. Silva Junior Charles O. Silveira Felipe S. Falcão Marília P. Alves Jório A.A.A. Mota Joyce B. Lima Rosa M.S. Mota Ana Patrícia F. Vieira Alexandre B. Libório FACTORS ASSOCIATED WITH THROMBOCYTOPENIA IN HUMAN LEPTOSPIROSIS Mediterranean Journal of Hematology and Infectious Diseases Leptospirosis Thrombocytopenia Platelets Acute kidney injury Mortality. |
author_facet |
Elizabeth De Francesco Daher Geraldo B. Silva Junior Charles O. Silveira Felipe S. Falcão Marília P. Alves Jório A.A.A. Mota Joyce B. Lima Rosa M.S. Mota Ana Patrícia F. Vieira Alexandre B. Libório |
author_sort |
Elizabeth De Francesco Daher |
title |
FACTORS ASSOCIATED WITH THROMBOCYTOPENIA IN HUMAN LEPTOSPIROSIS |
title_short |
FACTORS ASSOCIATED WITH THROMBOCYTOPENIA IN HUMAN LEPTOSPIROSIS |
title_full |
FACTORS ASSOCIATED WITH THROMBOCYTOPENIA IN HUMAN LEPTOSPIROSIS |
title_fullStr |
FACTORS ASSOCIATED WITH THROMBOCYTOPENIA IN HUMAN LEPTOSPIROSIS |
title_full_unstemmed |
FACTORS ASSOCIATED WITH THROMBOCYTOPENIA IN HUMAN LEPTOSPIROSIS |
title_sort |
factors associated with thrombocytopenia in human leptospirosis |
publisher |
PAGEPress Publications |
series |
Mediterranean Journal of Hematology and Infectious Diseases |
issn |
2035-3006 |
publishDate |
2014-08-01 |
description |
Background: This study was conducted to investigate factors associated with thrombocytopenia in a large cohort of patients with leptospirosis in an endemic area.
Patients and Methods: This is a retrospective study including 374 consecutive patients with leptospirosis admitted to tertiary hospitals in Fortaleza, Brazil. All patients had diagnosis of leptospirosis, and acute kidney injury (AKI) was defined according to the RIFLE criteria. Thrombocytopenia was defined as platelets count lower than 100,000/mm3.
Results: A total of 374 patients were included, with a mean age of 36.1±15.5 years, and 83.4% were male. Thrombocytopenia was present at hospital admission in 200 cases (53.5%) and developed during hospital stay in 150 cases (40.3%). Patients with thrombocytopenia had a higher frequency of dehydration (53% vs. 35.3%, p=0.001), epistaxis (5.7% vs. 0.8%, p=0.033), hematemesis (13% vs. 4.6%, p=0.006), myalgia (91.5% vs. 84.5%, p=0.038), hematuria (54.8% vs. 37.6%, p=0.011), metabolic acidosis (18% vs. 9.2%, p=0.016) and hypoalbuminemia (17.8% vs. 7.5%, p=0.005). Independent risk factors associated with thrombocytopenia during hospital stay were length of disease (OR: 1.2, p=0.001) and AKI (OR: 6.6, p=0.004). Mortality was not associated with thrombocytopenia at admission (12.5% vs. 12.6%, p=1.000) or during hospital stay (12.6% vs. 11.3%, p=0.748).
Conclusions: Thrombocytopenia is a frequent complication in leptospirosis, which was present in more than half of patients at hospital admission. The length of disease and AKI are risk factors for thrombocytopenia. There was no significant association between thrombocytopenia and mortality. Advanced age and oliguria were independent risk factors for death.
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topic |
Leptospirosis Thrombocytopenia Platelets Acute kidney injury Mortality. |
url |
https://mjhid.org/index.php/mjhid/article/view/1752 |
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