Augustina Isioma Ikusemoro: Why Routine Platelet Transfusion Is Not Always Recommended in Dengue
Augustina Isioma Ikusemoro, Hematology and Transfusion Medicine Specialist at Sharjah Blood Transfusion and Research Center, shared a post on LinkedIn:
“In Dengue, low platelets alone are not the enemy – poor clinical judgment is.
One of the most common misconceptions in dengue management is:
‘Low platelet count equals automatic platelet transfusion.’
But the science says otherwise.
Platelet transfusion in dengue is not routine treatment.
Dengue bleeding is not driven by thrombocytopenia alone.
It is also caused by:
- Increased capillary leak
- Platelet dysfunction
- Bone marrow suppression
- Coagulopathy and plasma leakage
So the real question is not:
‘What is the platelet count?’
The better question is:
‘What is the patient’s clinical condition?’
When should platelet transfusion be considered?
- Active or significant bleeding
- Severe thrombocytopenia in selected high-risk patients
- Falling platelet counts with warning signs
- Before invasive procedures when clinically indicated
But in a stable patient without bleeding?
Routine prophylactic platelet transfusion is usually not recommended – even when platelet counts are low.
Why?
Because unnecessary transfusions can lead to:
- Transfusion reactions
- Volume overload
- Wastage of a precious blood resource
The key lesson?
Treat the patient – not just the platelet count.
In transfusion medicine, wisdom is knowing when not to transfuse.
Think clinical. Assess risk. Transfuse wisely. Save lives.
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Better Blood. Better Care. Better Outcomes.”
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