Dengue in Renal Transplant Patients: A Retrospective Analysis

Abstract

We reviewed the impact of dengue in 27 renal transplant recipients (9 females and 18 males) at a mean of 63 (6-287) months after transplantation. Their mean age was 37+/-14 years and all were first transplantations (21 live donors, 6 deceased donors). Twenty-six were dengue fever cases and one had dengue hemorrhagic fever. Symptoms were: fever (100%), muscular pain (90%), malaise (75%), and headache (68%). Eight (29%) patients were admitted to hospital with one death. All other cases had full recovery. Mean serum creatinine before dengue was 1.4+/-0.6 mg/dL, increased to a mean peak of 1.9+/-1.2 mg/dL (P<0.001), and returned to baseline after recovery (1.6+/-0.82 mg/dL, P=NS). After a mean follow-up of 39+/-18 months, four patients lost their grafts due to chronic allograft nephropathy and four died, due to infectious causes not related to dengue. The first episode of dengue in transplanted patients resembled a flu-like syndrome, as in the general population. It did not cause long-term damage to either the patient or the graft.

Dengue Fever Among Renal Transplant Recipients: A Series of 10 Cases in a Tropical Country

“…Clinical presentation and the course of the disease in immunosuppressed patients is similar to that seen in immunocompetent patients, 2 except for a longer period of illness. 8 In this study, the main clinical signs and symptoms were myalgia and headache (100%), fever (90%), arthralgia (40%), bleeding manifestation (30%), retro-orbital pain, and rash and ascites (20%).…”

“…As the increase in serum creatinine was mild and transient in some cases, it was likely caused by dehydration or factors associated with infection rather than by a direct effect of the dengue virus on the kidney. 2 Long-term renal function was not affected in patients who did not lose their grafts. Eight of our patients had mild increase in creatinine that returned to basal levels after recovery.…”

“…2,8 This could be explained by the concept of cytokine, antibody-dependent enhancement, and T-cell-mediated process with activation of the immune response. In this case series, we had six patients with DF and four with DHF, but dengue asymptomatic infection had a high prevalence, and the real incidence in this population was unknown.…”

“…[1][2][3][4][5] Kidney transplant patients that live in endemic zones or who travel to an endemic zone might be affected by this disease, similar to the general population. Previous studies suggest that dengue infection is mild in renal transplant recipients, with good recovery, and that the disease does not affect allograft function.…”

Acute Tubular Necrosis Associated with Non-Hemorrhagic Dengue Fever: A Case Report

“…[4,10,[19][20][21][22] It is noteworthy that DF may have a benign form in renal transplant recipients. [23,24] Histopathological diagnosis of the acute renal failure is scarce, and it seems that most of the ATN diagnosis is formulated on clinical grounds. The patient under discussion had a confirmed acute tubular necrosis within the context of DF without DHF.…”