Dengue virus-associated hemophagocytic syndrome and dyserythropoiesis: a case report.
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.
Lu
Po-Liang
PL
Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Hsiao
Hui-Hwa
HH
Tsai
Jih-Jin
JJ
Chen
Tun-Chieh
TC
Feng
Ming-Chu
MC
Chen
Tyen-Po
TP
Lin
Sheng-Fung
SF
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