Dengue hemorhagic fever associated hemophagocytc lymphohistiocytosis in primigravida: A case report

Rationale: Hemophagocytic lymphohistiocytosis (HLH) is a rare but severe complication of dengue virus infection, associated with high mortality. We report a case of a 9-week primigravida presenting with high grade fever spikes and a positive Dengue NS1 antigen. The patient exhibited worsening clinic...

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Main Authors: Pyrus Bhellum, Rakesh Kumar, Rishabh Bora, Bharat Kumar
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-12-01
Series:Asian Pacific Journal of Tropical Medicine
Subjects:
Online Access:https://journals.lww.com/10.4103/apjtm.apjtm_376_24
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author Pyrus Bhellum
Rakesh Kumar
Rishabh Bora
Bharat Kumar
author_facet Pyrus Bhellum
Rakesh Kumar
Rishabh Bora
Bharat Kumar
author_sort Pyrus Bhellum
collection DOAJ
description Rationale: Hemophagocytic lymphohistiocytosis (HLH) is a rare but severe complication of dengue virus infection, associated with high mortality. We report a case of a 9-week primigravida presenting with high grade fever spikes and a positive Dengue NS1 antigen. The patient exhibited worsening clinical parameters, including cytopenias. Patient concerns: A primigravida at 9th week of gestation and this condition has limited diagnostic modalities and treatment options for HLH. Diagnoses: HLH secondary to dengue hemorrhagic fever. Outcomes: Intravenous steroids were initiated with monitoring of laboratory and clinical parameters. The patient recovered successfully after initiation of intravenous steroids. Oral steroids were subsequently tapered over an next eight-week period, leading to a successful recovery. Lessons: This case is unique due to the interplay between dengue virus infection, HLH, and early pregnancy, characterized by overlapping clinical symptoms and limited treatment options. Prompt initiation of intravenous steroid therapy resulted in significant clinical improvement. This case highlights the critical importance of early identification and treatment of dengue associated HLH to reduce mortality. Furthermore, it underscores the urgent need for focused research on HLH in pregnant patients, particularly in low and middle income countries.
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publisher Wolters Kluwer Medknow Publications
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series Asian Pacific Journal of Tropical Medicine
spelling doaj-art-f2fe221cf398491a8de8b126eabd63a22025-01-07T04:55:34ZengWolters Kluwer Medknow PublicationsAsian Pacific Journal of Tropical Medicine2352-41462024-12-01171256356710.4103/apjtm.apjtm_376_24Dengue hemorhagic fever associated hemophagocytc lymphohistiocytosis in primigravida: A case reportPyrus BhellumRakesh KumarRishabh BoraBharat KumarRationale: Hemophagocytic lymphohistiocytosis (HLH) is a rare but severe complication of dengue virus infection, associated with high mortality. We report a case of a 9-week primigravida presenting with high grade fever spikes and a positive Dengue NS1 antigen. The patient exhibited worsening clinical parameters, including cytopenias. Patient concerns: A primigravida at 9th week of gestation and this condition has limited diagnostic modalities and treatment options for HLH. Diagnoses: HLH secondary to dengue hemorrhagic fever. Outcomes: Intravenous steroids were initiated with monitoring of laboratory and clinical parameters. The patient recovered successfully after initiation of intravenous steroids. Oral steroids were subsequently tapered over an next eight-week period, leading to a successful recovery. Lessons: This case is unique due to the interplay between dengue virus infection, HLH, and early pregnancy, characterized by overlapping clinical symptoms and limited treatment options. Prompt initiation of intravenous steroid therapy resulted in significant clinical improvement. This case highlights the critical importance of early identification and treatment of dengue associated HLH to reduce mortality. Furthermore, it underscores the urgent need for focused research on HLH in pregnant patients, particularly in low and middle income countries.https://journals.lww.com/10.4103/apjtm.apjtm_376_24dengue haemorrhagic feverhemophagocytic lymphohistiocytosishlhpregnant femaledexamethasone
spellingShingle Pyrus Bhellum
Rakesh Kumar
Rishabh Bora
Bharat Kumar
Dengue hemorhagic fever associated hemophagocytc lymphohistiocytosis in primigravida: A case report
Asian Pacific Journal of Tropical Medicine
dengue haemorrhagic fever
hemophagocytic lymphohistiocytosis
hlh
pregnant female
dexamethasone
title Dengue hemorhagic fever associated hemophagocytc lymphohistiocytosis in primigravida: A case report
title_full Dengue hemorhagic fever associated hemophagocytc lymphohistiocytosis in primigravida: A case report
title_fullStr Dengue hemorhagic fever associated hemophagocytc lymphohistiocytosis in primigravida: A case report
title_full_unstemmed Dengue hemorhagic fever associated hemophagocytc lymphohistiocytosis in primigravida: A case report
title_short Dengue hemorhagic fever associated hemophagocytc lymphohistiocytosis in primigravida: A case report
title_sort dengue hemorhagic fever associated hemophagocytc lymphohistiocytosis in primigravida a case report
topic dengue haemorrhagic fever
hemophagocytic lymphohistiocytosis
hlh
pregnant female
dexamethasone
url https://journals.lww.com/10.4103/apjtm.apjtm_376_24
work_keys_str_mv AT pyrusbhellum denguehemorhagicfeverassociatedhemophagocytclymphohistiocytosisinprimigravidaacasereport
AT rakeshkumar denguehemorhagicfeverassociatedhemophagocytclymphohistiocytosisinprimigravidaacasereport
AT rishabhbora denguehemorhagicfeverassociatedhemophagocytclymphohistiocytosisinprimigravidaacasereport
AT bharatkumar denguehemorhagicfeverassociatedhemophagocytclymphohistiocytosisinprimigravidaacasereport