Revista da Sociedade Brasileira de Medicina Tropical 46(6):765-768, Nov-Dec, 2013http://dx.doi. org/10.1590/0037-8682-1716-2013 Dengue infection in children and adolescents: Clinical profi le in a reference hospital in northeast Brazil ABSTRACT Introduction:This study aimed to describe the clinical spectrum of dengue in children and adolescents from a hyperendemic region who were admitted for hospitalization. Methods: A retrospective study was conducted on patients diagnosed with dengue infection upon admission to a reference center in Fortaleza, Brazil. Results: Of the 84 patients included, 42 underwent confi rmatory testing. The main symptoms were fever, abdominal pain and vomiting. The median level of serum aspartate aminotransferase was 143.5±128mg/dL. Conclusions: A peculiar clinical profi le was evident among children and adolescents with dengue infection in a reference center in northeast Brazil, including gastrointestinal symptoms and liver involvement.

Visceral leishmaniasis (VL) is an endemic parasitic disease frequently found in Northeast Brazil and may cause acute kidney injury (AKI) and glomerulonephritis. After appropriate treatment, renal function recovery may occur. We describe the rare case of a patient with VL, who developed severe AKI requiring dialysis and was subsequently diagnosed with Chagas disease coinfection. After specific treatment for VL, there was partial recovery of the renal function, followed by the onset of Chagas disease cardiomyopathy.

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Systemic lupus erythematosus (SLE) is a pathology capable of affecting several organs and systems of the human body, including the central nervous system. The most common psychiatric manifestations addressed in studies are acute confusional state, mood disorders, cognitive dysfunction, psychosis, among others. However, there are few documented case reports associating lupus with an episode of mania, mainly because this neuropsychiatric symptom usually precedes the onset of typical SLE symptoms, such as malar rash or arthralgias. The objective of this study is to describe the case of a patient hospitalized for diagnostic investigation of SLE who presented with mania.

The complement-mediated thrombotic microangiopathy (TMA), also known as atypical hemolytic uremic syndrome (aHUS), is rare and potentially fatal, presenting as TMA and dysfunction/endothelial edema secondary to diffuse disruption of a fluid phase alternating complementary pathways. We report a case of a young woman with postpartum anuric renal failure, TMA and normal levels of AD-AMTS13 with partial clinical improvement after plasmapheresis, in which treatment with eculizumab led to the complete reversal of the clinical manifestations. Our work includes a brief literature review on the diagnosis and management of TMA in puerperium.