Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. May 8, 2017; 6(2): 118-123
Published online May 8, 2017. doi: 10.5409/wjcp.v6.i2.118
Significance of platelet count in children admitted with bronchiolitis
Amar Al Shibli, Najla Alkuwaiti, May Hamie, Dima Abukhater, Muhammad B Noureddin, Abdulla Amri, Salwa Al Kaabi, Aysha Al Kaabi, Mariam Harbi, Hassib Narchi
Amar Al Shibli, Najla Alkuwaiti, May Hamie, Dima Abukhater, Muhammad B Noureddin, Abdulla Amri, Salwa Al Kaabi, Aysha Al Kaabi, Mariam Harbi, Department of Pediatrics, Tawam Hospital, PO Box 15258, Al Ain, United Arab Emirates
Hassib Narchi, Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates
Author contributions: Al Shibli A designed the research, coordinated and supervised data collection, co-wrote and supervised the report; Narchi H designed the study, the data collection instruments, carried out the analyses and co-wrote the manuscript; Hamie M, Abukhater D, Noureddin MB, Al Kaabi S, Al Kaabi A, Alkuwaiti N and Al Harbi M collected the data, reviewed and revised the manuscript, and approved the final manuscript as submitted; all authors have approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Institutional review board statement: Institutional Review Board (IRB 296/13) and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. The requirement for consent was waived as it was a retrospective study and patient anonymity was preserved.
Informed consent statement: As this was a retrospective review of case notes where all the clinical data was anonymized, patients were not required to give informed consent to the study.
Conflict-of-interest statement: The authors have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Amar Al Shibli, FRCPCH, Department of Pediatrics, Tawam Hospital, PO Box 15258, Al Ain, United Arab Emirates. ashibli@seha.ae
Telephone: +971-3-7677444
Received: April 27, 2016
Peer-review started: May 3, 2016
First decision: July 27, 2016
Revised: October 23, 2016
Accepted: November 21, 2016
Article in press: November 22, 2016
Published online: May 8, 2017
Processing time: 384 Days and 2.3 Hours
Abstract
AIM

To determine the true prevalence of thrombocytosis in children less than 2 years of age with bronchiolitis, its association with risk factors, disease severity and thromboembolic complications.

METHODS

A retrospective observational medical chart review of 305 infants aged two years or less hospitalized for bronchiolitis. Clinical outcomes included disease severity, duration of hospital stay, admission to pediatric intensive care unit, or death. They also included complications of thrombocytosis, including thromboembolic complications such as cerebrovascular accident, acute coronary syndrome, deep venous thrombosis, pulmonary embolus, mesenteric thrombosis and arterial thrombosis and also hemorrhagic complications such as bleeding (spontaneous hemorrhage in the skin, mucous membranes, gastrointestinal, respiratory, or genitourinary tracts).

RESULTS

The median age was 4.7 mo and 179 were males (59%). Respiratory syncytial virus was isolated in 268 (84%), adenovirus in 23 (7%) and influenza virus A or B in 13 (4%). Thrombocytosis (platelet count > 500 × 109/L) occurred in 88 (29%; 95%CI: 24%-34%), more commonly in younger infants with the platelet count declining with age. There was no significant association with the duration of illness, temperature on admission, white blood cell count, serum C-reactive protein concentration, length of hospital stay or admission to the intensive care unit. No death, thrombotic or hemorrhagic events occurred.

CONCLUSION

Thrombocytosis is common in children under two years of age admitted with bronchiolitis. It is not associated with disease severity or thromboembolic complications.

Keywords: Hospitalization; Bronchiolitis; Platelet count; Thrombocytosis; Infant; Virus diseases

Core tip: This is as a retrospective observational study of platelet counts in 305 infants aged two years or less who were hospitalized for bronchiolitis. Thrombocytosis (platelet count > 500 × 109/L) was frequent, occurring in 88 (29%; 95%CI: 24%-34%), more commonly in younger infants with the platelet count declining with age. There was no significant association with the duration of illness, temperature on admission, white blood cell count, serum C-reactive protein concentration, length of hospital stay, admission to the intensive care unit, death, thrombotic or hemorrhagic complications.