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- Title
“Towards the End of Spectrum; Dengue Fever with Secondary Hemophagocytic Histiolymphohistiocytosis”.
- Authors
Mazlan, Nur Aishah; Haidar Hazlan, Siti Nur; Razali, Mohamad Hafis; Amri Yusoff, Muhammad Khairul; A’Idrus, Farah Farhana
- Abstract
Dengue fever is the most common arboviral disease transmitted globally. It was estimated about 400,000 cases of severe dengue occur in Asian countries. Patients with severe dengue are at risk of developing secondary Haemophagocytic Lymphohistiocytosis (HLH) which contribute to high morbidity and mortality. Thus, a high index of suspicion should be considered in critical dengue patient. We presented a case of young girl, who initially had classical symptoms and sign of dengue fever and was in compensated shock at presentation. The condition further deteriorated as she developed Acute respiratory distress syndrome (ARDS) and secondary HLH due to severe infection. She developed unremitting fever despite already out of defervenscence window period. With some positive laboratory findings; highly elevated serum ferritin of more than 10,000 mcg/L, low natural killer (NK) cells, bicytopenias and hypertriglyceridemia in which directed towards diagnosis of secondary HLH. However, due to ill condition, the bone marrow aspiration was not able to be performed to confirm the presence of haemophagocytosis. HLH is a hyper inflammatory condition which is characterized by macrophage activation with phagocytosis of blood cells in the bone marrow and cytokine storm, leading to organ dysfunction and death.
- Subjects
DENGUE hemorrhagic fever; DENGUE; HYPERFERRITINEMIA; SYMPTOMS; ADULT respiratory distress syndrome; ARBOVIRUS diseases
- Publication
Malaysian Journal of Medicine & Health Sciences, 2024, Vol 20, p136
- ISSN
1675-8544
- Publication type
Case Study
- DOI
10.47836/mjmhs20.s3.21