title: Dengue infection associated hemophagocytic syndrome: Therapeutic interventions and outcome.
abstract: Infection associated hemophagocytic syndrome is increasingly recognized as a potentially fatal complication of dengue fever. It should be suspected with prolonged fever beyond seven days associated with hepatosplenomegaly, hyperferritinemia, worsening cytopenias and development of multiorgan dysfunction. Surge of similar pro-inflammatory cytokines observed in dengue associated hemophagocytic syndrome and multiorgan dysfunction may indicate they are part of related inflammatory spectrum. A proportion of patients recovered with supportive therapy, however most required interventions with corticosteroids, intravenous immunoglobulin or chemotherapy. We report three cases of dengue associated IAHS with good outcome following early recognition and treatment with dexamethasone and intravenous immunoglobulin.
authors.affiliation: Cell Therapy Center, Universiti Kebangsaan Malaysia Medical Center, 56000 Kuala Lumpur, Malaysia. Electronic address: wanfariza@ppukm.ukm.edu.my.
authors.forename: Wan Fariza
authors.initials: WF
authors.lastname: Wan Jamaludin
authors.affiliation: Department of Medicine (Infectious Disease), Universiti Kebangsaan Malaysia Medical Center, 56000 Kuala Lumpur, Malaysia. Electronic address: petrick@ppukm.ukm.edu.my.
authors.forename: Petrick
authors.initials: P
authors.lastname: Periyasamy
authors.affiliation: Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Center, 56000 Kuala Lumpur, Malaysia. Electronic address: docaweng@yahoo.com.
authors.forename: Wan Rahiza
authors.initials: WR
authors.lastname: Wan Mat
authors.affiliation: Cell Therapy Center, Universiti Kebangsaan Malaysia Medical Center, 56000 Kuala Lumpur, Malaysia. Electronic address: sfadilah@ppukm.ukm.edu.my.
authors.forename: S Fadilah
authors.initials: SF
authors.lastname: Abdul Wahid
mesh_terms: D061605:Administration, Intravenous; D000293:Adolescent; D000328:Adult; D003715:Dengue / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D003907:Dexamethasone / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D051359:Lymphohistiocytosis, Hemophagocytic / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D016756:Immunoglobulins, Intravenous; D003907:Dexamethasone
keywords: Corticosteroids; Dengue; Hemophagocytic syndrome; Intravenous immunoglobulin