Severe dengue in the early postoperative period after kidney transplantation: two case reports from Hospital Geral de Fortaleza

Maia, Samuelson Hugo Félix; Brasil, Ivelise Regina Canito; Esmeraldo, Ronaldo de Matos; Ponte, Carlos Roger Sales da; Costa, Rebeca Carvalho Souza; Lira, Roberta Alves

doi:10.1590/0037-8682-0205-2015

Cited by 23 publications

(16 citation statements)

References 11 publications

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“…We reviewed two large cross sectional studies, three case series and four case reports. In one study only the abstract was available [11], and in the other immunosuppression protocol was absent [12], however we used data on symptomatology, lab investigations and mortality. The total number of subjects described in literature was 168.…”

Section: Resultsmentioning

confidence: 99%

Dengue fever in renal transplant patients: a systematic review of literature

2017

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BackgroundDengue fever in renal transplanted patients has not been studied well, and we review all the literature about episodes dengue fever in renal transplant patients.MethodsThe aim was to describe clinico-pathological characteristics, immunosuppressive protocols, need renal outcome and mortality. PubMed, LILACS, Google Scholar and Research Gate were searched for “Dengue” and “Renal/Kidney Transplantation” with no date limits. Hits were analyzed by two researchers separately.ResultsFever, myalgia, arthralgia and headache was significantly lower than normal population, while pleural effusions and ascites were observed more. Incidence of severe dengue is significantly higher among transplant patients in this review, as well as they had a significantly higher mortality (8.9% vs 3.7%, p = 0.031). Age, period after transplantation and immunosuppressive profile had no effect on disease severity, mortality or graft out come. Presence of new bleeding complications and ascites was associated with more severe disease (p < 0.001 and p = 0.005), death (p = 0.033) or graft loss (p = 0.035). Use of tacrolimus was associated with new bleeding complications (p = 0.027), and with ascites (p = 0.021), but not with thrombocytopenia. 25% of patients with primary disease fail to mount an IgG response by 15 weeks of the illness. 58.9% had graft dysfunction during illness. Postoperative transplanted patients were at risk of severe disease and unfavorable outcome.ConclusionsThe physical and laboratory findings in dengue fever in renal transplanted patients differ from the general population. Some degree of graft dysfunction is common during the illness, but only a minority develops graft failure.

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Section: Resultsmentioning

confidence: 99%

Dengue fever in renal transplant patients: a systematic review of literature

2017

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“…Studies had shown that approximately 8.9% mortality was associated with dengue infection among renal transplant recipients [11]. In some cases mortality is a direct effect of bleeding [2], while others were due to secondary causes (for example, sepsis, type 1 respiratory failure) [7, 8]. …”

Section: Discussionmentioning

confidence: 99%

“…Here we report a case of DF in a post kidney transplant patient in a background of chronic active hepatitis B infection. Information on confirmed cases of DF among solid organ transplant recipients in the literature is limited, with very few fatalities; most of the fatalities occurring during the immediate post transplant period [2, 4]. Complete recovery of a post liver transplant recipient with DF was reported locally [9].…”

Section: Introductionmentioning

confidence: 99%

Dengue fever in a kidney transplant recipient with complicated clinical course: a case report

2018

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BackgroundDengue fever is the commonest mosquito-borne illness in the tropics and subtropics. Renal transplantation is one of the ever expanding modes of treatment of end-stage renal disease. Hepatitis B is a common infection in South and East Asia, but rare in Sri Lanka. Here we describe a recipient of a renal transplant with a stable graft, on antiviral treatment for hepatitis B infection, developing dengue superinfection and entering a complex clinical course. To the best of our knowledge this is the first report of such a case.Case presentationA 59-year-old Sri Lankan woman developed acute renal failure and needed dialysis support; she had upper gastrointestinal bleeding that needed transfusions, pancytopenia, and a prolonged phase of thrombocytopenia. She eventually recovered from illness, and her renal functions returned to baseline levels. The differences in presentation, signs, symptoms, and mortality of renal transplant recipients infected with dengue fever from the general population are discussed, with possible reasons for altered presentation.ConclusionsDengue superinfection in transplant recipients with hepatitis B infection can lead to management difficulties. The recovery can be slow as seen from this case, with prolonged thrombocytopenia.

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“…According to the literature, case reports generally show dengue as a severe disease in immunocompromised patients with mortality rates >40% . On the other hand, dengue case series have shown that the disease can be mild in some transplant populations, such as kidney recipients .…”

Section: Discussionmentioning

confidence: 99%

Prolonged viremia in dengue virus infection in hematopoietic stem cell transplant recipients and patients with hematological malignancies

Pereira

Darrigo

Costa

et al. 2017

Transplant Infectious Dis

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Fever, skin rash, headache, and thrombocytopenia are considered hallmarks of dengue infection. However, these symptoms are frequently observed in infectious and non-infectious complications of hematopoietic stem cell transplant recipients and oncohematological patients. Thus, laboratory confirmation of dengue is relevant for prompt intervention and proper management of dengue in endemic and non-endemic regions. Because no prospective study of dengue has been conducted in these populations, the actual morbidity and mortality of dengue is unknown. In the present series, we describe five cases of dengue in patients living in endemic areas, emphasizing the prolonged course of the disease and the occurrence of prolonged viremia.

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Severe dengue in the early postoperative period after kidney transplantation: two case reports from Hospital Geral de Fortaleza

Cited by 23 publications

References 11 publications

Dengue fever in renal transplant patients: a systematic review of literature

Dengue fever in renal transplant patients: a systematic review of literature

Dengue fever in a kidney transplant recipient with complicated clinical course: a case report

Prolonged viremia in dengue virus infection in hematopoietic stem cell transplant recipients and patients with hematological malignancies

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