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1 ORIGINL RTICLE The Correlation Between Thrombopoietin and Platelet Count in dult Dengue Viral Infection Patients snath Vera Matondang*, Djoko Widodo**, Iskandar Zulkarnain**, Iris Rengganis***, Suhendro**, Indang Trihandini****, Katsuya Inada*****, Shigeatsu Endo****** BSTRCT im: to investigate alteration in humoral regulation during the course of dengue viral infection Methods: a prospective analytic study had been conducted involving 4 subjects with dengue viral infection. Subjects were recruited according to consecutive non-probability sampling. Subjects were categorized according to days of illness, platelet counts and serum thrombopoietin (TPO) levels.

The plasma TPO levels examinations were done once daily until the platelet counts reached more than 1,/mm3. Results: statistical analysis showed the mean serum TPO levels were increased during thrombocytopenia phase of the disease, and differ significantly from the convalescent phase (mean value 428pg/ml vs 22.1 pg/ml, p =.). There was also a statistically significant inverse correlation between serum TPO levels and platelet counts (p =.). Conclusion: TPO levels were significantly increased in adult patients with dengue infection in which platelets in circulation were markedly reduced, and the TPO levels were inversely related to the platelet counts. Key words: TPO levels, platelet count, dengue fever infection. * Department of Internal Medicine, Faculty of Medicine, University of Indonesia,Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta ** Division of Tropical-Infectious, ***Division of lergy Immunology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia,Dr.

Cipto Mangunkusumo National Central General Hospital, Jakarta **** Public Health Faculty, University of Indonesia, Jakarta ***** Immunology and Endotoxin Research Laboratory Dept.of Bacteriology School of Medicine Iwate Medical University, Japan ****** Director of Critical Care and Emergency Center Iwate Medical University, Japan INTRODUCTION Dengue hemorrhagic fever (DHF) defined as an acute fever caused by dengue viral infection. DHF has significant morbidity and mortality in many southeast sian countries. The prominent features of DHF were thrombocytopenia and plasma leakage. These conditions were the key diagnostic tools to differentiate dengue fever (DF) and dengue hemorrhagic fever (DHF). The cause of thrombocytopenia in DHF is still controversial.

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Some experts presumed it might be due to derangements in thrombopoiesis and increased platelets destruction in circulation. Other studies also found the presence of platelet dysfunction. 2-4 Bone marrow has an important role in inducing thrombocytopenia. Suppression on the hematopoietic system occurred during dengue viral infection. Platelet production originating from megacaryocytes in bone marrow was a steady ongoing process. From published clinical studies, TPO has been known as the main regulator substance of megacaryocytes and thrombopoiesis to maintain adequate platelet counts in circulation. Significant increased of TPO levels is found in patient with low circulating level of megacaryocytes and platelets.

5,6 Based on these results, it was considered important to know the profile of TPO in dengue viral infection. Im of the study was to investigate the alteration in humoral regulation of thrombopoiesis during course of dengue viral infection in adults and find the correlation between platelet counts and plasma TPO levels in dengue viral infection. METHODS This research was a prospective analytic observational study, conducted from January to June 2 in Internal Medicine ward in Medical Faculty University of Indonesia, Dr. Cipto Mangunkusumo National General Hospital, Jakarta and Persahabatan hospital. Subjects were recruited based on consecutive non 62 2 Vol 36 Number 2 pril-june 24 The Correlation Between Coagulation Test and lbumin probability sampling methods. Patients with dengue viral infection who met the inclusion criteria and did not have any exclusion criteria were recruited in this study. The inclusion criteria were male or female patients whose age between 14 and 6 years old.