title: Dengue virus-associated hemophagocytic syndrome and dyserythropoiesis: a case report.
abstract: A 33-year-old man had dengue hemorrhagic fever with initial presentation of fever, leukocytosis, and thrombocytopenia. The cause of the subsequent rapid decline in red cell counts without evidence of intravascular hemolysis or massive bleeding was confirmed as hemophagocytosis and dyserythropoiesis by bone marrow study. The patient recovered with supportive care and the bone marrow pattern was normal on repeated bone marrow study. To our knowledge, this is the first reported case of dengue virus-associated hemophagocytosis and dyserythropoiesis in Taiwan. Clinicians should consider that the occurrence of hemophagocytosis and dyserythropoiesis could be due to dengue virus infection. That this dengue virus infection was confirmed by a positive serology result at the convalescent stage but not at the acute symptomatic stage underlines the need for a second dengue serology study, as dengue infection can be missed due to an initial negative serology result.
authors.affiliation: Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Po-Liang
authors.initials: PL
authors.lastname: Lu
authors.forename: Hui-Hwa
authors.initials: HH
authors.lastname: Hsiao
authors.forename: Jih-Jin
authors.initials: JJ
authors.lastname: Tsai
authors.forename: Tun-Chieh
authors.initials: TC
authors.lastname: Chen
authors.forename: Ming-Chu
authors.initials: MC
authors.lastname: Feng
authors.forename: Tyen-Po
authors.initials: TP
authors.lastname: Chen
authors.forename: Sheng-Fung
authors.initials: SF
authors.lastname: Lin
mesh_terms: D000328:Adult; D001791:Blood Platelet Disorders / Q000209:etiology; D001853:Bone Marrow / Q000378:metabolism; D001856:Bone Marrow Examination; D003716:Dengue Virus; D004632:Emergency Medical Services; D004900:Erythroblasts / Q000473:pathology; D004920:Erythropoiesis / Q000502:physiology; D015616:Histiocytosis, Non-Langerhans-Cell / Q000209:etiology*; D006801:Humans; D006965:Hyperplasia / Q000209:etiology; D008297:Male; D011379:Prognosis; D019595:Severe Dengue / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology