Hubungan Nilai Immature Platelet Fraction (IPF) Dengan Kejadian Trombositopenia Pada Pasien Demam Berdarah Dengue
Article Sidebar
Main Article Content
Abstract
Demam berdarah dengue (DBD) merupakan masalah kesehatan utama di negara tropis dengan manifestasi khas trombositopenia, namun mekanisme dan respon sumsum tulang terhadap penurunan trombosit belum sepenuhnya dimanfaatkan dalam praktik klinis. Immature Platelet Fraction (IPF) menggambarkan fraksi trombosit muda di sirkulasi dan berpotensi menjadi penanda tidak langsung trombopoiesis pada trombositopenia terkait infeksi dengue. Tujuan penelitian ini enilai hubungan nilai IPF dengan kejadian trombositopenia pada pasien DBD dengan antigen NS1 positif serta membandingkan nilai IPF pasien DBD dan non DBD. Studi deskriptif analitik menggunakan data sekunder laboratorium dari 14 pasien DBD dengan trombositopenia dan 14 subjek sehat sebagai kontrol di Rumah Sakit Yarsi Jakarta, periode November 2024-Maret 2025; pemeriksaan DENV dilakukan dengan uji cepat antigen NS1 dan IgM/IgG, sedangkan IPF diukur menggunakan Sysmex XN‑1000, kemudian dianalisis dengan uji T independen dan uji korelasi Pearson. Hasil rerata IPF pasien DBD adalah 8,5% (SD 2,34) dan pasien non DBD 2,3% (SD 1,36) dengan perbedaan bermakna (p<0,05), serta 93% pasien DBD dengan trombositopenia menunjukkan IPF tinggi. Terdapat korelasi negatif yang kuat dan signifikan antara jumlah trombosit dan IPF (p<0,05; r = -0,79), yang menunjukkan bahwa penurunan trombosit berkaitan dengan peningkatan IPF. Nilai IPF meningkat secara bermakna pada pasien DBD dengan trombositopenia dan berkorelasi kuat dengan penurunan jumlah trombosit, sehingga IPF berpotensi digunakan sebagai indikator laboratorium untuk memantau trombositopenia dan respon trombopoiesis pada DBD.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
All rights reserved. This publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording.
References
Abeysuriya, V., Seneviratne, S. L., de Mel, P., Clarice, C. S. H., de Mel, C., Chandrasena, L., Yip, C., Yap, E.-S., & de Mel, S. (2022). The immature platelet fraction, a predictive tool for early recovery from dengue-related thrombocytopenia: a prospective study. Transactions of the Royal Society of Tropical Medicine and Hygiene, 116(5), 424—432. https://doi.org/10.1093/trstmh/trab135
Asghar, M. B., Akhtar, F., Mahmood, A., Rafique, N., Rana, N. A., & Khalid, U. Bin. (2023). Diagnostic Accuracy of Immature Platelet Fraction (IPF) to Differentiate Between Thrombocytopenia due to Peripheral Destruction versus Bone Marrow Failure. Journal of the College of Physicians and Surgeons Pakistan, 760–764. https://doi.org/10.29271/jcpsp.2023.07.760
Asha, J., Baiju, N. M., Innah, S. J., Rafi, A., & John, B. M. (2023). Comparison of platelet indices in dengue fever patients based on platelet transfusion. Asian Journal of Transfusion Science, 17(1), 21–27. https://doi.org/10.4103/ajts.AJTS_24_20
Azin, F. R. F. G., Gonçalves, R. P., Pitombeira, M. H. da S., Lima, D. M., & Branco, I. C. (2012). Dengue: profile of hematological and biochemical dynamics. Revista Brasileira de Hematologia e Hemoterapia, 34(1), 36–41. https://doi.org/10.5581/1516-8484.20120012
Baihaki, I., Dewi, B. E., Kharisma, V. D., Murtadlo, A. A. A., Tamam, M. B., Purnamasari, D., Soekamto, N. H., Ansori, A., Kuswati, K., Mandeli, R. S., Aledresi, K. A. M. S., Mukdasai, S., Yusof, N. F. M., Jakhmola, V., Rebezov, M., Burkov, P., Derkho, M., Scherbakov, P., Zainul, R., … Haryuna, T. S. H. (2023). Correlation of the Presence of Non Structural-1 (NS1) Antigen Dengue Virus with Severity of Dengue Infection. Pharmacognosy Journal, 14(6), 813–816. https://doi.org/10.5530/pj.2022.14.172
Baihaki, I., Sari, G. P., & Soraya. (2025). Asscociation Between Dengue Virus NS1 Antigen and Interleukin-6 9IL-6) Levels as a Predictor of Inflammatoty Response in Dengue Hemorrhagic Fever. African Journal of Biology Sciences, 7(10), 390–396.
Bhatt, S., Gething, P. W., Brady, O. J., Messina, J. P., Farlow, A. W., Moyes, C. L., Drake, J. M., Brownstein, J. S., Hoen, A. G., Sankoh, O., Myers, M. F., George, D. B., Jaenisch, T., Wint, G. R. W., Simmons, C. P., Scott, T. W., Farrar, J. J., & Hay, S. I. (2013). The global distribution and burden of dengue. Nature, 496(7446), 504–507. https://doi.org/10.1038/nature12060
Chao, C.-H., Wu, W.-C., Lai, Y.-C., Tsai, P.-J., Perng, G.-C., Lin, Y.-S., & Yeh, T.-M. (2019). Dengue virus nonstructural protein 1 activates platelets via Toll-like receptor 4, leading to thrombocytopenia and hemorrhage. PLoS Pathogens, 15(4), e1007625. https://doi.org/10.1371/journal.ppat.1007625
García-Larragoiti, N., Kim, Y. C., López-Camacho, C., Cano-Méndez, A., López-Castaneda, S., Hernández-Hernández, D., Vargas-Ruiz, Á. G., Vázquez-Garcidueñas, M. S., Reyes-Sandoval, A., & Viveros-Sandoval, M. E. (2021). Platelet activation and aggregation response to dengue virus nonstructural protein 1 and domains. Journal of Thrombosis and Haemostasis : JTH, 19(10), 2572–2582. https://doi.org/10.1111/jth.15431
Goel, G., Semwal, S., Khare, A., Joshi, D., Amerneni, C. K., Pakhare, A., & Kapoor, N. (2021). Immature Platelet Fraction: Its Clinical Utility in Thrombocytopenia Patients. Journal of Laboratory Physicians, 13(03), 214–218. https://doi.org/10.1055/s-0041-1729471
Kementerian Kesehatan. (2024). Waspada DBD di Musim Kemarau.
Kraemer, M. U. G., Sinka, M. E., Duda, K. A., Mylne, A. Q. N., Shearer, F. M., Barker, C. M., Moore, C. G., Carvalho, R. G., Coelho, G. E., Van Bortel, W., Hendrickx, G., Schaffner, F., Elyazar, I. R. F., Teng, H.-J., Brady, O. J., Messina, J. P., Pigott, D. M., Scott, T. W., Smith, D. L., … Hay, S. I. (2015). The global distribution of the arbovirus vectors Aedes aegypti and Ae. albopictus. ELife, 4, e08347. https://doi.org/10.7554/eLife.08347
Looi, K. W., Matsui, Y., Kono, M., Samudi, C., Kojima, N., Ong, J. X., Tan, C. A., Ang, C. S., Tan, P. H. Y., Shamnugam, H., Sekaran, S. D., Syed Omar, S. F., & Lum, L. C. S. (2021). Evaluation of immature platelet fraction as a marker of dengue fever progression. International Journal of Infectious Diseases, 110, 187–194. https://doi.org/10.1016/j.ijid.2021.07.048
Noisakran, S., Onlamoon, N., Hsiao, H.-M., Clark, K. B., Villinger, F., Ansari, A. A., & Perng, G. C. (2012). Infection of bone marrow cells by dengue virus in vivo. Experimental Hematology, 40(3), 250-259.e4. https://doi.org/10.1016/j.exphem.2011.11.011
Patro, A. R. K., Mohanty, S., Prusty, B. K., Singh, D. K., Gaikwad, S., Saswat, T., Chattopadhyay, S., Das, B. K., Tripathy, R., & Ravindran, B. (2019). Cytokine Signature Associated with Disease Severity in Dengue. Viruses, 11(1). https://doi.org/10.3390/v11010034
Pokharel, A., Pokhrel, B., Bhattarai, R., & Khanal, M. (2024). Changes in the Liver Function and Hematological Parameters in Dengue Patients at a Tertiary Care Center: A Descriptive Cross-sectional Study. Journal of Nepal Medical Association, 62(274), 382–386. https://doi.org/10.31729/jnma.8616
Puc, I., Ho, T.-C., Chien, Y.-W., Tan, S.-S., Fong, Y.-C., Chen, Y.-J., Wang, S.-H., Li, Y.-H., Chen, C.-H., Chen, P.-L., Perng, G.-C., & Tsai, J.-J. (2022). Mobilization of Hematopoietic Stem and Progenitor Cells during Dengue Virus Infection. International Journal of Molecular Sciences, 23(22). https://doi.org/10.3390/ijms232214330
Stanaway, J. D., Shepard, D. S., Undurraga, E. A., Halasa, Y. A., Coffeng, L. E., Brady, O. J., Hay, S. I., Bedi, N., Bensenor, I. M., Castañeda-Orjuela, C. A., Chuang, T.-W., Gibney, K. B., Memish, Z. A., Rafay, A., Ukwaja, K. N., Yonemoto, N., & Murray, C. J. L. (2016). The global burden of dengue: an analysis from the Global Burden of Disease Study 2013. The Lancet. Infectious Diseases, 16(6), 712–723. https://doi.org/10.1016/S1473-3099(16)00026-8
WHO. (2021). Dengue and Severe Dengue. In WHO : Geneva.
World Health Organization (WHO). (2009). Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control.
Yamasaki, S., Hashiguchi, M., Yoshida-Sakai, N., Jojima, H., Osaki, K., Okamura, T., & Imamura, Y. (2025). Immature platelet fraction and bone marrow findings in hematology. Scientific Reports. https://doi.org/10.1038/s41598-025-33069-5