Dengue virus infection among renal transplant recipients in Singapore: a 15-year, single-centre retrospective review
Introduction: Dengue is a mosquito-borne viral infection endemic in Singapore. Its impact on renal transplantation is limited to small case series. We aimed to characterise the clinical presentation and outcomes of dengue infection among renal transplant recipients in Singapore. Methods: We conducte...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer – Medknow Publications
2024-04-01
|
| Series: | Singapore Medical Journal |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.11622/smedj.2021167 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1823863799589896192 |
|---|---|
| author | Sophie Seine Xuan Tan Quan Yao Ho Sobhana Thangaraju Thuan Tong Tan Terence Kee Shimin Jasmine Chung |
| author_facet | Sophie Seine Xuan Tan Quan Yao Ho Sobhana Thangaraju Thuan Tong Tan Terence Kee Shimin Jasmine Chung |
| author_sort | Sophie Seine Xuan Tan |
| collection | DOAJ |
| description | Introduction:
Dengue is a mosquito-borne viral infection endemic in Singapore. Its impact on renal transplantation is limited to small case series. We aimed to characterise the clinical presentation and outcomes of dengue infection among renal transplant recipients in Singapore.
Methods:
We conducted a 15-year retrospective review of dengue in renal transplant patients treated at Singapore General Hospital between January 2005 and October 2019. The diagnosis of dengue was made if there were a compatible clinical syndrome and a positive dengue diagnostic assay (dengue non-structural 1 antigen, immunoglobulin M or reverse transcriptase-polymerase chain reaction).
Results:
Of the 31 patients diagnosed with dengue, 18 (58.1%) were deceased donor recipients. The median age was 52 (interquartile range [IQR] 40–61) years; 16 (51.6%) were females. The median time to diagnosis was 99 (IQR 18–169) months from transplant. The most common clinical symptoms were fever (87.1%), myalgia (41.9%), gastrointestinal symptoms (38.7%) and headache (25.8%). Nineteen (61.3%) patients had dengue without warning signs, nine (29.0%) had dengue with warning signs, three (9.7%) had severe dengue and 30 (96.8%) were hospitalised. Seventeen (54.8%) patients had graft dysfunction, 16 (94.1%) of whom had recovery of graft function. One (3.2%) patient required dialysis and subsequently died. There were two cases of donor-derived infections (DDIs) with favourable outcomes.
Conclusion:
Our experience with dengue in renal transplant recipients is concordant with published data. Although graft dysfunction is common, it is often transient with favourable outcomes. Outpatient management may be considered for mild infections. Although dengue DDIs are uncommon, more stringent donor screening may be considered in endemic regions. |
| format | Article |
| id | doaj-art-de06a57bf03a4dafa3ec82e548b7bd6d |
| institution | Kabale University |
| issn | 0037-5675 2737-5935 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | Wolters Kluwer – Medknow Publications |
| record_format | Article |
| series | Singapore Medical Journal |
| spelling | doaj-art-de06a57bf03a4dafa3ec82e548b7bd6d2025-02-09T10:21:45ZengWolters Kluwer – Medknow PublicationsSingapore Medical Journal0037-56752737-59352024-04-0165423524110.11622/smedj.2021167Dengue virus infection among renal transplant recipients in Singapore: a 15-year, single-centre retrospective reviewSophie Seine Xuan TanQuan Yao HoSobhana ThangarajuThuan Tong TanTerence KeeShimin Jasmine ChungIntroduction: Dengue is a mosquito-borne viral infection endemic in Singapore. Its impact on renal transplantation is limited to small case series. We aimed to characterise the clinical presentation and outcomes of dengue infection among renal transplant recipients in Singapore. Methods: We conducted a 15-year retrospective review of dengue in renal transplant patients treated at Singapore General Hospital between January 2005 and October 2019. The diagnosis of dengue was made if there were a compatible clinical syndrome and a positive dengue diagnostic assay (dengue non-structural 1 antigen, immunoglobulin M or reverse transcriptase-polymerase chain reaction). Results: Of the 31 patients diagnosed with dengue, 18 (58.1%) were deceased donor recipients. The median age was 52 (interquartile range [IQR] 40–61) years; 16 (51.6%) were females. The median time to diagnosis was 99 (IQR 18–169) months from transplant. The most common clinical symptoms were fever (87.1%), myalgia (41.9%), gastrointestinal symptoms (38.7%) and headache (25.8%). Nineteen (61.3%) patients had dengue without warning signs, nine (29.0%) had dengue with warning signs, three (9.7%) had severe dengue and 30 (96.8%) were hospitalised. Seventeen (54.8%) patients had graft dysfunction, 16 (94.1%) of whom had recovery of graft function. One (3.2%) patient required dialysis and subsequently died. There were two cases of donor-derived infections (DDIs) with favourable outcomes. Conclusion: Our experience with dengue in renal transplant recipients is concordant with published data. Although graft dysfunction is common, it is often transient with favourable outcomes. Outpatient management may be considered for mild infections. Although dengue DDIs are uncommon, more stringent donor screening may be considered in endemic regions.https://journals.lww.com/10.11622/smedj.2021167denguerenal transplantsingapore |
| spellingShingle | Sophie Seine Xuan Tan Quan Yao Ho Sobhana Thangaraju Thuan Tong Tan Terence Kee Shimin Jasmine Chung Dengue virus infection among renal transplant recipients in Singapore: a 15-year, single-centre retrospective review Singapore Medical Journal dengue renal transplant singapore |
| title | Dengue virus infection among renal transplant recipients in Singapore: a 15-year, single-centre retrospective review |
| title_full | Dengue virus infection among renal transplant recipients in Singapore: a 15-year, single-centre retrospective review |
| title_fullStr | Dengue virus infection among renal transplant recipients in Singapore: a 15-year, single-centre retrospective review |
| title_full_unstemmed | Dengue virus infection among renal transplant recipients in Singapore: a 15-year, single-centre retrospective review |
| title_short | Dengue virus infection among renal transplant recipients in Singapore: a 15-year, single-centre retrospective review |
| title_sort | dengue virus infection among renal transplant recipients in singapore a 15 year single centre retrospective review |
| topic | dengue renal transplant singapore |
| url | https://journals.lww.com/10.11622/smedj.2021167 |
| work_keys_str_mv | AT sophieseinexuantan denguevirusinfectionamongrenaltransplantrecipientsinsingaporea15yearsinglecentreretrospectivereview AT quanyaoho denguevirusinfectionamongrenaltransplantrecipientsinsingaporea15yearsinglecentreretrospectivereview AT sobhanathangaraju denguevirusinfectionamongrenaltransplantrecipientsinsingaporea15yearsinglecentreretrospectivereview AT thuantongtan denguevirusinfectionamongrenaltransplantrecipientsinsingaporea15yearsinglecentreretrospectivereview AT terencekee denguevirusinfectionamongrenaltransplantrecipientsinsingaporea15yearsinglecentreretrospectivereview AT shiminjasminechung denguevirusinfectionamongrenaltransplantrecipientsinsingaporea15yearsinglecentreretrospectivereview |