Hemolytic Uremic Syndrome Associated with Dengue Fever in an Adolescent Girl

Successful treatment of thrombotic microangiopathy associated with dengue infection: A case report and literature review

“…TMA associated with dengue is very rare and scarcely described; it may be caused by either TTP or HUS; the reported cases are summarized in Table . It is believed that TTP is secondary to an alteration in the activity of the enzyme ADAMTS13, because antibody formation against this protein has been documented, and because there is an increased consumption of it because of stimulation of endothelial cells; neurological compromise is more frequent and renal involvement usually less severe, with good response to plasma exchange .…”

“…Few cases of HUS secondary to dengue have been reported; the first one was documented in 2006, with TMA in a renal biopsy with microtubuloreticular structures that suggested viral infection . The second one was reported in 2014 as an exclusion diagnosis in a patient with microangiopathic hemolytic anemia with renal compromise, response to plasmapheresis, and dengue as the only etiologic agent found; without relapse at 6‐month follow‐up . The third one was an 8‐year‐old boy with anemia, thrombocytopenia, renal failure, and hypertensive crisis who received supportive therapy .…”

“…it may be caused by either TTP or HUS; the reported cases are summarized in Table 2. 5,22,23 It is believed that TTP is secondary to an alteration in the activity of the enzyme ADAMTS13, because antibody formation against this protein has been documented, and because there is an increased consumption of it because of stimulation of endothelial cells; 6,24 neurological compromise is more frequent and renal involvement usually less severe, with good response to plasma exchange. 6 In our patient, we initially considered this possibility; however, at the beginning he was very resistant to plasma exchange, and when the results of ADAMTS13 activity finally arrived, we definitively ruled it out.…”

Dengue fever-induced thrombotic microangiopathy: An unusual cause of renal failure

“…[810] A few cases of dengue fever-associated thrombotic microangiopathy have been described recently. [1112]…”

“…At 6 months of follow-up, the child was asymptomatic with normal renal function. [11] Another case of dengue fever-associated hemolytic uremic syndrome with hypertensive crisis has been described in an 8-year-old boy from Indonesia. The patient was managed with hemodialysis, antihypertensive medications, and supportive care.…”