Utilization of Scatter gram Patterns in the Mindray BC-6800 Hematology Analyzer for Early Diagnosis of Dengue Infection: A Novel Automated Analyzer-Based Study

Abstract

Background: Dengue is a rapidly emerging mosquito-borne viral infection that poses a major public health challenge in tropical countries. Early diagnosis is crucial for timely supportive management and prevention of complications. Automated hematology analyzers provide scatter gram patterns that may serve as valuable adjuncts for the early identification of dengue infection. This study aimed to evaluate lymphocyte scatterogram patterns generated by the Mindray BC-6800 hematology analyzer in laboratory-confirmed dengue cases and assess their association with severe thrombocytopenia.

Methods: This retrospective observational study was conducted at Sree Balaji Medical College and Hospital, Chennai, India. Patients presenting with acute febrile illness between September and November 2021 with laboratory-confirmed dengue infection by NS1 antigen and/or anti-dengue IgM/IgG serology were included. Hematological parameters, including platelet count, and lymphocyte scatter gram patterns obtained from the Mindray BC-6800 automated hematology analyzer were analyzed.

Results: A total of 102 patients with confirmed dengue infection were included. Eighty (78.4%) patients demonstrated atypical lymphocytosis with varying degrees of thrombocytopenia. A characteristic figure-of-eight lymphocyte scatter gram pattern was consistently observed in patients with atypical lymphocytosis and severe thrombocytopenia. This distinctive pattern was absent in patients without significant hematological abnormalities and served as an early indicator of severe dengue-related changes.

Conclusion: The figure-of-eight scatter gram pattern identified on the Mindray BC-6800 analyzer is a promising laboratory marker associated with atypical lymphocytosis and severe thrombocytopenia in dengue infection. Recognition of this characteristic pattern may facilitate early clinical suspicion, expedite confirmatory testing, and support timely initiation of appropriate patient management. Further prospective multicentre studies are warranted to validate its diagnostic and prognostic utility.