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[Comment] Time to stop prophylactic platelet transfusion for adult dengue

Thrombocytopenia is a common manifestation of dengue infection.1 The complex pathogenesis entails not only decreased platelet production due to bone marrow suppression and attenuation of megakaryocyte maturation, but also increased peripheral platelet destruction.2 Thrombocytopenia in dengue fever is transient, and spontaneous recovery in platelet count is almost always observed.1 The exact pathogenesis of bleeding in dengue is not fully understood and is thought to be multifactorial. Although low platelet count is considered a risk factor for bleeding in adult dengue,3 a direct correlation between the degree of thrombocytopenia and risk of bleeding—as documented in other disorders such as acute leukaemia4—has not been observed.