Dengue and aplastic anemia--a rare association.
Aplastic anemia is a medullary insufficiency secondary to the complete or partial disappearance of hematopoietic tissue without abnormal cellular proliferation. This is a rare complication of infections, such as dengue hemorrhagic fever. A 15-year-old girl was admitted with anemia, bleeding from the gums, petechiae and fever. Laboratory tests at the time of admission showed: Hemoglobin 4.8 g/dl; Hematocrit 13.4%; white blood count 2240/microl and platelets 11,500/microl. Dengue virus IgM antibodies were found. A bone marrow aspirate and biopsy showed severe aplastic anemia. Treatment with intravenous immunoglobulin and methylprednisolone was started. The patient had a favorable outcome. She was then given long-term treatment with cyclosporin. She is now in remission, without any symptoms. Dengue can induce aplastic anemia through direct bone marrow invasion. This is a rare complication which must be identified early. Immunosuppressive therapy can induce complete remission.
Albuquerque
Polianna L M M
PL
Division of Internal Medicine, Hospital Geral César Cals, and School of Medicine, Universidade Estadual do Ceará, Fortaleza, Ceará, Brazil. pollylemos@yahoo.com.br
Silva Júnior
Geraldo B
GB
Diógenes
Saulo S
SS
Silva
Herivaldo F
HF
D000293:Adolescent; D000741:Anemia, Aplastic / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001938:Brazil; D003715:Dengue / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D003716:Dengue Virus / Q000302:isolation & purification; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D008775:Methylprednisolone / Q000627:therapeutic use; D012074:Remission Induction
D000893:Anti-Inflammatory Agents; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D008775:Methylprednisolone