TNF and Thrombocytopenia: Dengue virus can inhibit the production of white blood cells and platelets in the bone marrow of patients, resulting in leukopenia and thrombocytopenia.[41] TNF, also known as tumor necrosis factor, has been linked to bleeding in patients during dengue infection.[42] CSJD may regulate the level of TNF in vivo to control bleeding and thus improve patients symptoms.