Factors associated with thrombocytopenia in severe leptospirosis (Weil's disease)
AUTOR(ES)
Daher, Elizabeth F., Silva, Geraldo B., Silveira, Charles O., Falcao, Felipe S., Alves, Marilia P., Mota, Jorio A.A.A., Lima, Joyce B., Mota, Rosa M.S., Vieira, Ana Patricia F., Pires, Roberto da Justa, Liborio, Alexandre B.
FONTE
Clinics
DATA DE PUBLICAÇÃO
2014-02
RESUMO
OBJECTIVE: This study was conducted to investigate factors associated with thrombocytopenia in a large cohort of patients with leptospirosis in an endemic area. METHODS: This retrospective study included 374 consecutive patients with leptospirosis who were admitted to tertiary hospitals in Fortaleza, Brazil. All patients had a diagnosis of severe leptospirosis (Weil's disease). Acute kidney injury was defined according to the RIFLE criteria. Thrombocytopenia was defined as a platelet count <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 the time of hospital admission in 200 cases (53.5%), and it developed during the hospital stay in 150 cases (40.3%). The patients with thrombocytopenia had higher frequencies 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). The independent risk factors associated with thrombocytopenia during the hospital stay were lengthy disease (OR: 1.2, p = 0.001) and acute kidney injury (OR: 6.6, p = 0.004). Mortality was not associated with thrombocytopenia at admission (12.5% vs. 12.6%, p = 1.000) or during the hospital stay (12.6% vs. 11.3%, p = 0.748). CONCLUSIONS: Thrombocytopenia is a frequent complication in leptospirosis, and this condition was present in more than half of patients at the time of hospital admission. Lengthy disease and acute kidney injury are risk factors for thrombocytopenia. There was no significant association between thrombocytopenia and mortality.
Documentos Relacionados
- Occurrence and risk factors associated with canine leptospirosis
- Risk factors associated with leptospirosis in swine in state of Pernambuco, Brazil
- Delayed Mortality and Attenuated Thrombocytopenia Associated with Severe Malaria in Urokinase- and Urokinase Receptor-Deficient Mice
- Cardiovascular drugs and analysis of potential risk factors associated with mortality in severe coronavirus disease 2019 patients
- Plasmodium vivax malaria presenting with severe thrombocytopenia