{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T15:45:54Z","timestamp":1792165554416,"version":"4.4.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,1,11]],"date-time":"2025-01-11T00:00:00Z","timestamp":1736553600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,1,11]],"date-time":"2025-01-11T00:00:00Z","timestamp":1736553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"DOI":"10.1186\/s12879-025-10486-5","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T09:25:04Z","timestamp":1736933104000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Leukopenia and thrombocytopenia in dengue patients presenting in the emergency department of a tertiary center in Nepal: a cross-sectional study"],"prefix":"10.1186","volume":"25","author":[{"given":"Bibechan","family":"Thapa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3462-528X","authenticated-orcid":false,"given":"Prakriti","family":"Lamichhane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trishna","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saral","family":"Lamichhane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreyasi","family":"Karki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sneha","family":"Pradhananga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kabita Hada","family":"Batajoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prajwal","family":"Pudasaini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,11]]},"reference":[{"key":"10486_CR1","unstructured":"World Health Organization: WHO, World Health Organization: WHO. Dengue and severe dengue. www.who.int. 2023; Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/dengue-and-severe-dengue"},{"key":"10486_CR2","unstructured":"About Dengue| CDC. Centers for Disease Control and Prevention. 2023. Available from: https:\/\/www.cdc.gov\/dengue\/about\/index.html"},{"key":"10486_CR3","unstructured":"Prevention, management and control of dengue in Nepal. Government of Nepal Ministry of Health and Population; 2019 [cited 2023 Jul 7]. Available from: https:\/\/www.who.int\/docs\/default-source\/nepal-documents\/national-guidelines-on-prevention-management-and-control-of-dengue-in-nepal.pdf?sfvrsn=e02216fd_2"},{"key":"10486_CR4","unstructured":"World Health Organization. Comprehensive guideline for prevention and control of dengue and dengue hemorrhagic fever. B4751.pdf (who.int)."},{"issue":"1","key":"10486_CR5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s40249-021-00837-0","volume":"10","author":"KR Rijal","year":"2021","unstructured":"Rijal KR, Adhikari B, Ghimire B, Dhungel B, Pyakurel UR, Shah P, Bastola A, Lekhak B, Banjara MR, Pandey BD, Parker DM. Epidemiology of dengue virus infections in Nepal, 2006\u20132019. Infect Dis Poverty. 2021;10(1):1\u20130.","journal-title":"Infect Dis Poverty"},{"key":"10486_CR6","unstructured":"Dengue guidelines for diagnosis, treatment, prevention and control: new edition. Apps.who.int. 2009. [Fulltext]."},{"key":"10486_CR7","unstructured":"Interpreting platelet results. | Diagnosis | Platelets. NICE. [cited 2023Apr21]. [Fulltext]."},{"key":"10486_CR8","doi-asserted-by":"publisher","unstructured":"Sabeena S, Chandrabharani K, Ravishankar N, Arunkumar G. Classification of dengue cases in Southwest India based on the WHO systems-a retrospective analysis. Trans R Soc Trop Med Hyg. 2018;112(11):479\u2013485. https:\/\/doi.org\/10.1093\/trstmh\/try080. PMID: 30107616.","DOI":"10.1093\/trstmh\/try080"},{"key":"10486_CR9","doi-asserted-by":"publisher","unstructured":"Singh J, Dinkar A, Singh RG, Siddiqui MS, Sinha N, Singh SK. Clinical profile of dengue fever and coinfection with chikungunya. Tzu Chi Med J. 2018 Jul-Sep;30(3):158\u201364. https:\/\/doi.org\/10.4103\/tcmj.tcmj_138_17. PMID: 30069124; PMCID: PMC6047329.","DOI":"10.4103\/tcmj.tcmj_138_17"},{"issue":"1","key":"10486_CR10","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/s12941-018-0284-7","volume":"17","author":"BP Gupta","year":"2018","unstructured":"Gupta BP, Haselbeck A, Kim JH, Marks F, Saluja T. The Dengue virus in Nepal: gaps in diagnosis and surveillance. Ann Clin Microbiol Antimicrob. 2018;17(1):32. https:\/\/doi.org\/10.1186\/s12941-018-0284-7. PMID: 30008269; PMCID: PMC6047123.","journal-title":"Ann Clin Microbiol Antimicrob"},{"issue":"2","key":"10486_CR11","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.4103\/jfmpc.jfmpc_926_19","volume":"9","author":"K Mohan","year":"2020","unstructured":"Mohan K, Malaiyan J, Nasimuddin S, Devasir RS, Meenakshi-Sundaram P, Selvaraj S, Krishnasamy B, Gnanadesikan S, Karthikeyan M, Kandasamy M, Jayakumar N, Elumalai D, Ra GG. Clinical profile and atypical manifestation of dengue fever cases between 2011 and 2018 in Chennai, India. J Family Med Prim Care. 2020;9(2):1119\u201323. https:\/\/doi.org\/10.4103\/jfmpc.jfmpc_926_19. PMID: 32318478; PMCID: PMC7113926.","journal-title":"J Family Med Prim Care"},{"issue":"2","key":"10486_CR12","doi-asserted-by":"publisher","first-page":"507","DOI":"10.3390\/v15020507","volume":"15","author":"S Rimal","year":"2023","unstructured":"Rimal S, Shrestha S, Pandey K, Nguyen TV, Bhandari P, Shah Y, Acharya D, Adhikari N, Rijal KR, Ghimire P, Takamatsu Y, Pandey BD, Fernandez S, Morita K, Ngwe Tun MM, Dumre SP. Co-circulation of Dengue Virus Serotypes 1, 2, and 3 during the 2022 Dengue Outbreak in Nepal: a cross-sectional study. Viruses. 2023;15(2):507. https:\/\/doi.org\/10.3390\/v15020507. PMID: 36851721; PMCID: PMC9958792.","journal-title":"Viruses"},{"key":"10486_CR13","doi-asserted-by":"publisher","unstructured":"Singh A, Hungund B, Kumar L, Pattanshetti M. Clinico-hematological profile of patients with bicytopenia. Pathology. 2018;50(5):540\u2013548. https:\/\/doi.org\/10.1016\/j.pathol.2018.03.008. Epub 2018 Jul 4. PMID: 30032928.","DOI":"10.1016\/j.pathol.2018.03.008"},{"issue":"1","key":"10486_CR14","first-page":"12","volume":"5","author":"SF Lin","year":"1989","unstructured":"Lin SF, Liu HW, Chang CS, Yen JH, Chen TP. [Hematological aspects of dengue fever]. Gaoxiong Yi Xue Ke Xue Za Zhi. 1989;5(1):12\u20136. Chinese. PMID: 2733062.","journal-title":"Gaoxiong Yi Xue Ke Xue Za Zhi"},{"key":"10486_CR15","doi-asserted-by":"publisher","first-page":"2904422","DOI":"10.1155\/2023\/2904422","volume":"2023","author":"BR Bhattarai","year":"2023","unstructured":"Bhattarai BR, Mishra A, Aryal S, Chhusyabaga M, Bhujel R. Association of Hematological and Biochemical Parameters with serological markers of Acute Dengue infection during the 2022 Dengue Outbreak in Nepal. J Trop Med. 2023;2023:2904422. https:\/\/doi.org\/10.1155\/2023\/2904422. PMID: 36873099; PMCID: PMC9981284.","journal-title":"J Trop Med"},{"issue":"1","key":"10486_CR16","doi-asserted-by":"publisher","first-page":"4","DOI":"10.4103\/0973-6247.28065","volume":"1","author":"RN Makroo","year":"2007","unstructured":"Makroo RN, Raina V, Kumar P, Kanth RK. Role of platelet transfusion in the management of dengue patients in a tertiary care hospital. Asian J Transfus Sci. 2007;1(1):4\u20137. https:\/\/doi.org\/10.4103\/0973-6247.28065. PMID: 21938225; PMCID: PMC3168133.","journal-title":"Asian J Transfus Sci"},{"key":"10486_CR17","doi-asserted-by":"publisher","first-page":"313842","DOI":"10.1155\/2015\/313842","volume":"2015","author":"EL de Azeredo","year":"2015","unstructured":"de Azeredo EL, Monteiro RQ, de-Oliveira Pinto LM. Thrombocytopenia in Dengue: interrelationship between Virus and the imbalance between Coagulation and Fibrinolysis and Inflammatory mediators. Mediators Inflamm. 2015;2015:313842. https:\/\/doi.org\/10.1155\/2015\/313842. Epub 2015 Apr 27. PMID: 25999666; PMCID: PMC4427128.","journal-title":"Mediators Inflamm"},{"key":"10486_CR18","doi-asserted-by":"publisher","unstructured":"Kalayanarooj S, Vaughn DW, Nimmannitya S, Green S, Suntayakorn S, Kunentrasai N, Viramitrachai W, Ratanachu-eke S, Kiatpolpoj S, Innis BL, Rothman AL, Nisalak A, Ennis FA. Early clinical and laboratory indicators of acute dengue illness. J Infect Dis. 1997;176(2):313\u2009\u2013\u200921. https:\/\/doi.org\/10.1086\/514047. PMID: 9237695.","DOI":"10.1086\/514047"},{"key":"10486_CR19","doi-asserted-by":"publisher","unstructured":"Thach TQ, Eisa HG, Hmeda AB, Faraj H, Thuan TM, Abdelrahman MM, Awadallah MG, Ha NX, Noeske M, Abdul Aziz JM, Nam NH, Nile ME, Dumre SP, Huy NT, Hirayama K. Predictive markers for the early prognosis of dengue severity: A systematic review and meta-analysis. PLoS Negl Trop Dis. 2021;15(10):e0009808. https:\/\/doi.org\/10.1371\/journal.pntd.0009808. Erratum in: PLoS Negl Trop Dis. 2022;16(1):e0010164. PMID: 34610027; PMCID: PMC8519480.","DOI":"10.1371\/journal.pntd.0009808"},{"issue":"7","key":"10486_CR20","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1016\/S1473-3099(20)30601-0","volume":"21","author":"S Sangkaew","year":"2021","unstructured":"Sangkaew S, Ming D, Boonyasiri A, Honeyford K, Kalayanarooj S, Yacoub S, Dorigatti I, Holmes A. Risk predictors of progression to severe disease during the febrile phase of dengue: a systematic review and meta-analysis. Lancet Infect Dis. 2021;21(7):1014\u201326. https:\/\/doi.org\/10.1016\/S1473-3099(20)30601-0. Epub 2021 Feb 25. PMID: 33640077; PMCID: PMC8240557.","journal-title":"Lancet Infect Dis"},{"issue":"8","key":"10486_CR21","doi-asserted-by":"publisher","first-page":"e0009666","DOI":"10.1371\/journal.pntd.0009666","volume":"15","author":"T Adane","year":"2021","unstructured":"Adane T, Getawa S. Coagulation abnormalities in Dengue fever infection: a systematic review and meta-analysis. PLoS Negl Trop Dis. 2021;15(8):e0009666. https:\/\/doi.org\/10.1371\/journal.pntd.0009666. PMID: 34407078; PMCID: PMC8372965.","journal-title":"PLoS Negl Trop Dis"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-025-10486-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-025-10486-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-025-10486-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T09:25:15Z","timestamp":1736933115000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-025-10486-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,11]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["10486"],"URL":"https:\/\/doi.org\/10.1186\/s12879-025-10486-5","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,11]]},"assertion":[{"value":"17 June 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 January 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures in this study involving human participants complied with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. Ethical approval was taken from Institutional Review Committee of KIST Medical College Teaching Hospital, Lalitpur, Nepal (IRC No. 2079\/80\/26). The need for consent to participate was waived by the Institutional Review Committee.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Clinical trial number: not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Clinical trial registration details"}}],"article-number":"56"}}