Dengue fever in renal allograft recipients: Clinical course and outcome

Subbiah, Arunkumar; Bagchi, Soumita; Bhowmik, Dipankar; Mahajan, Sandeep; Yadav, Rohitash; Chhabra, Yogesh; Agarwal, Sanjay Kumar

doi:10.1111/tid.12875

Cited by 13 publications

(16 citation statements)

References 11 publications

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“…According to published data, CHIKV in solid organ transplant recipients seems to have a benign course and favorable outcome (19,20), whereas data for DENV in these patients are less clear. Case descriptions report uncomplicated outcomes, whereas a recent literature review reported a significantly higher incidence of severe dengue and a higher mortality rate among transplant patients with dengue (21)(22)(23). A recent report of DENV, ZIKV, and CHIKV infections diagnosed in hematopoietic stem cell transplant recipients and oncohematologic patients found prolonged viremia in those with DENV and viruria in those with ZIKV; the most common complication was thrombocytopenia, but all patients survived without sequelae (24).…”

Section: Discussionmentioning

confidence: 99%

Imported Arbovirus Infections in Spain, 2009–2018

Norman¹,

Henriquez-Camacho²,

Díaz‐Menéndez³

et al. 2020

Emerg. Infect. Dis.

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Section: Discussionmentioning

confidence: 99%

Imported Arbovirus Infections in Spain, 2009–2018

Norman¹,

Henriquez-Camacho²,

Díaz‐Menéndez³

et al. 2020

Emerg. Infect. Dis.

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“…Additionally, there have been two new publications. In one, there were 11 cases in Brazil with no long-term damage to the patients or to the grafts [37] and, in the second, there were 20 cases in India with 40% of transient renal dysfunction, and 5% of death attributed to the DI [38].…”

Section: Discussionmentioning

confidence: 99%

Clinical and laboratorial profiles of dengue virus infection in kidney transplant recipients: Report of a single center

et al. 2019

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Dengue infection (DI) is the most important arboviral infection in the world. The majority of immunocompetent patients will have asymptomatic or mild infections, but the degree of dengue severity in kidney transplant recipients (KTx) is unknown. In this study, we report the clinical profile and outcomes of 39 dengue cases in KTx. From a total of 1,186 KTx outpatients in follow-up we reviewed clinical and laboratory records of 60 (5%) patients admitted with suspected DI initially screened by NS-1, IgM, and when possible, multiplex nested PCR. The prevalence of DI in KTx was 3% (39/1,118), with symptoms leading to hospital admission being fever, myalgia, malaise, and headache. Laboratory tests showed leucopenia, thrombocytopenia, and liver enzyme elevation. DI was confirmed by positivity of NS-1 (33%), IgM (69%), and/or RT-PCR (59%). Twenty-three patients (59%) had dengue with warning signs, and 15% had severe dengue, 2 of them with a fatal course. Acute graft dysfunction occurred in 59% (mean nadir serum creatinine: 2.9 ± 2.6mg/dL), 4 of them requiring dialysis. CMV coinfection diagnosed in 19% of the cases and patients was associated with worse clinical presentation. Our results suggest that KTx with DI presented initial physical and laboratorial profile similar to the general population. However, DI in KTx seems to have a higher risk for graft dysfunction, severe dengue, and death. Because CMV coinfection aggravates the DI clinical presentation and recovery, it must be evaluated in all cases.

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“…Therefore, because the intensity of immunosuppression does not determine the outcome of most patients, and because there is no specific therapy for dengue infection in transplant recipients, early diagnosis and supportive treatment are currently available tools for better clinical management 36, 41…”

Section: Denguementioning

confidence: 99%

Emergent Arboviruses and Renal Transplantation: A Global Challenge

Moura-Neto¹,

Silva²,

Moura³

et al. 2019

Kidney International Reports

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In recent years, Zika, Chikungunya, Dengue, West Nile Fever, and Yellow Fever epidemics have generated some concerns. Besides difficulties related to vector control, there are challenges related to behavior of pathologies not yet fully understood. The transplanted population requires additional care due to immunosuppressive drugs. Furthermore, the potential risk of transmission during donation is another source of uncertainty and generates debate among nephrologists in transplant centers. Do the clinical outcomes and prognoses of these infections tend to be more aggressive in this population? Is there a risk of viral transmission via kidney donation? In this review article, we address these issues and discuss the relationship between arbovirus and renal transplantation.

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Dengue fever in renal allograft recipients: Clinical course and outcome

Abstract: Clinical manifestations of dengue infection in renal transplant recipients were similar to that in general population. However, leucopenia necessitating temporary withdrawal of immunosuppression was common. Renal dysfunction was frequent but completely reversible.

Cited by 13 publications

References 11 publications

Imported Arbovirus Infections in Spain, 2009–2018

Imported Arbovirus Infections in Spain, 2009–2018

Clinical and laboratorial profiles of dengue virus infection in kidney transplant recipients: Report of a single center

Emergent Arboviruses and Renal Transplantation: A Global Challenge

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