Potential danger of isolated platelet transfusion in patients with dengue infection

Children treated with intensive plasmapheresis (which corrects the vWF–ADAMTS13 imbalance, by removing vWF multimers and providing ADAMTS13 by fresh frozen plasma infusions) had increase in plasma ADAMTS13 activity and reversal of organ failure [7]. [...]the sequence in critically ill patients who die of multi-organ system failure and thrombocytopenia appears to be systemic inflammatory response syndrome, leading to endothelial activation, platelet sequestration onto endothelium occluding microvasculature, organ system failure and death. Transfusion of activated platelet concentrates may have pro-thrombotic side effects [10]. [...]there is a potential for harm when isolated platelet transfusions (which may contain activated platelets) are given to a patient with dengue and thrombocytopenia (who probably has activated endothelium, onto which platelets stick). [...]the potential for harm by isolated platelet transfusions are higher in patients with DHF, DSS and possibly, in atypical presentation of dengue, compared to patients with stable uncomplicated dengue fever.