title: Dengue fever causing febrile neutropenia in children with acute lymphoblastic leukemia: an unknown entity.
abstract: Dengue fever is endemic in many parts of the world but it has not been described as a cause of febrile neutropenia. We describe here clinical features, laboratory values and outcome in 10 children with acute lymphoblastic leukemia (ALL) and with dengue fever as a cause of febrile neutropenia. These data are compared to an age-matched control population of 22 children with proven dengue infection without ALL. Except for fever in all patients and plethoric face in one patient, typical symptoms of dengue such as abdominal pain, myalgias, and headaches, were absent. Mean duration of hospital stay was 6.3±2.0 days in ALL patients vs. 5.0±2.0 in controls (p=0.096). Median platelet count was 13,000/cmm (range 1000-28,000) in cases vs. 31,500 (range 13,000-150,000) in controls (p=0.018). Mean time for recovery for platelet was 6.0±1.3days in ALL patients vs. 2.5±0.9days in controls (p<0.001). All 10 patients survived. In endemic areas, high suspicion of dengue fever should be maintained in children with ALL and febrile neutropenia although typical symptoms may be lacking. Platelet recovery may be significantly delayed.
authors.affiliation: Pediatric Hematology Oncology & BMT Unit, Department of Pediatrics, Sir Ganga Ram Hospital, Delhi, India.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Ramzan
authors.forename: Satya Prakash
authors.initials: SP
authors.lastname: Yadav
authors.forename: Veronique
authors.initials: V
authors.lastname: Dinand
authors.forename: Anupam
authors.initials: A
authors.lastname: Sachdeva
mesh_terms: D002648:Child; D003715:Dengue / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007902:Length of Stay; D009503:Neutropenia / Q000209:etiology*; D010976:Platelet Count; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000175:diagnosis*; D017361:Viral Nonstructural Proteins / Q000032:analysis
chemical_list: C082515:NS1 protein, dengue-1 virus; D017361:Viral Nonstructural Proteins