Autoimmune features caused by dengue fever: a case report

Abstract

Autoimmunity Hematologic diseases A B S T R A C TDengue virus is the most important mosquito-borne viral disease in the world. Co-circulation of the four types of dengue viruses and expansion of dengue epidemic gave rise to infection enhancement and a big expansion of clinical aspects of the disease. Herein we report a case of a 25-year-old white woman with dengue fever and numerous associated autoimmune features.Our patient had proteinuria, an extensive right pleural effusion, a thin pericardial effusion and ascites. She had a low C3 level and positive antinuclear antibody; cryoglobulins were also positive. The numerous autoimmune features of this patient were a diagnostic challenge, since she was a young woman and could be easily mistaken for a rheumatologic patient in a newly open disease. Dengue infection probably was a triggering event causing an abnormal immune response. Therefore, dengue should be suspected in patients with hematological disorders and autoimmune features in endemic regions or those who have travelled to those regions.

False-positive dengue IgM test result in a patient with systemic lupus erythematosus: a case report

“…A specific protein may cause a reaction similar to that of a cellular dengue virus infection. This reaction could be a cross reactivity between the NS1-specific disease, the host protein, the endothelial cells, and the platelets [6]. Another hypothesis is that autoimmune patients may have a rheumatoid factor that coats with anti-human IgM antibody and causes nonspecific binding [5].…”

“…Our case demonstrated a false-positive dengue test result in a patient with SLE patient who lives in dengueendemic country. Nonspecific symptoms of dengue infection can overlap with those of the autoimmune disorder, which subsequently causes confusion during the early clinical course [2,6]. Physical examinations should be conducted frequently to obtain clinical information on specific skin lesions.…”

“…Denguespecific tests including for dengue nonstructural protein 1 (NS1), dengue IgM, and dengue virus immunoglobulin G (dengue IgG) are widely used for diagnosis [4,5]. However, several studies have demonstrated false-positive dengue test results among patients with abnormal immune systems [6][7][8][9]. Data to guide physicians when assessing acute febrile patients with non-organ-specific symptoms in dengue-endemic areas are inadequate.…”

Unusual yet isolated oral manifestations of persistent thrombocytopenia: a rare case report

“…The advantages of this practice are reduced donor exposure, lower incidence of alloimmunization and lower refractoriness to platelet transfusions 18 . Dengue should hence be suspected in patients with hematological disorders and autoimmune features in endemic regions 7 . It is also important to recognize the oral manifestations of thrombocytopenia since the oral cavity is a frequent site of hemorrhage and may be the only manifestation of the disease.…”