Dengue Infection and Its Relationship with Evans Syndrome: A Pediatric Case
Dengue is a single-stranded RNA virus belonging to the Flaviviridae family. It is an endemic virus in tropical countries. In Colombia, 4 serotypes are present, and the disease is a burden for public health, social programs, and the economic sectors. The main vector is Aedes aegypti, and most infecti...
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Wiley
2021-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2021/8635585 |
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| author | Ivan Jose Ardila Gomez Pilar Pérez López Mónika Rocío Hernández Carreño Juan Camilo Barrios Torres |
| author_facet | Ivan Jose Ardila Gomez Pilar Pérez López Mónika Rocío Hernández Carreño Juan Camilo Barrios Torres |
| author_sort | Ivan Jose Ardila Gomez |
| collection | DOAJ |
| description | Dengue is a single-stranded RNA virus belonging to the Flaviviridae family. It is an endemic virus in tropical countries. In Colombia, 4 serotypes are present, and the disease is a burden for public health, social programs, and the economic sectors. The main vector is Aedes aegypti, and most infections are asymptomatic or minimally symptomatic. The hemorrhagic appearances of severe dengue are due to plasma leakage as a result of increased vascular permeability, severe thrombopenia, and hemoconcentration. In 2020, 78,979 cases of dengue were reported in Colombia. 38,836 (49.2%) of them were warning-free signs, 39,246 (49.7%) with warning signs, and 897 (1.1%) of severe dengue. As it is well-known, viral diseases are immune system activators, triggering off a loss of tolerance in it. Dengue is not an exception, and it is able to explain different autoimmune phenomena including macrophage activation. Mechanisms have been described by which an exacerbated response of the disease is triggered through the increase of infected cells, formation of immune complexes, and complement pathway activation, which lead to a cross-reaction of viral antigens with epithelial cells with platelets with subsequent endothelial dysfunction and bleeds. The first description of Evans syndrome was made in 1951 by Robert Evans. This syndrome is characterized by the combination of autoimmune hemolytic anemia, immune thrombocytopenia, and, less common/usual, immune neutropenia. This disease’s etiology is unknown, and the dysregulation of the immune system is among its possibilities. Here, we present the case of an unusual hematological and immunological complication of a patient who developed Evans syndrome during severe dengue, taking into account the concomitantly limited literature available for these two diseases, the need for a broader diagnostic approach, multidisciplinary intervention, and a more complex therapeutic approach. |
| format | Article |
| id | doaj-art-b45e6ea13692430f8333430033f3e6cb |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-b45e6ea13692430f8333430033f3e6cb2025-02-03T01:27:24ZengWileyCase Reports in Medicine1687-96271687-96352021-01-01202110.1155/2021/86355858635585Dengue Infection and Its Relationship with Evans Syndrome: A Pediatric CaseIvan Jose Ardila Gomez0Pilar Pérez López1Mónika Rocío Hernández Carreño2Juan Camilo Barrios Torres3Pediatric Critical Care, Uros Clinic-Neiva University Hospital, Professor at the Universidad Surcolombiana, Neiva, Huila, ColombiaPediatric Rheumatologist, Neiva University Hospital-Uros Clinic-Medilaser Clinic, Professor at the Universidad Surcolombiana, Neiva, Huila, ColombiaPediatrician and Epidemiologist Uros Clinic Medilaser Clinic, Neiva, Huila, ColombiaGeneral Physician Specialist in Health Quality Management and Audit, Hospital Medical Coordinator of Uros Clinic, Neiva, Huila, ColombiaDengue is a single-stranded RNA virus belonging to the Flaviviridae family. It is an endemic virus in tropical countries. In Colombia, 4 serotypes are present, and the disease is a burden for public health, social programs, and the economic sectors. The main vector is Aedes aegypti, and most infections are asymptomatic or minimally symptomatic. The hemorrhagic appearances of severe dengue are due to plasma leakage as a result of increased vascular permeability, severe thrombopenia, and hemoconcentration. In 2020, 78,979 cases of dengue were reported in Colombia. 38,836 (49.2%) of them were warning-free signs, 39,246 (49.7%) with warning signs, and 897 (1.1%) of severe dengue. As it is well-known, viral diseases are immune system activators, triggering off a loss of tolerance in it. Dengue is not an exception, and it is able to explain different autoimmune phenomena including macrophage activation. Mechanisms have been described by which an exacerbated response of the disease is triggered through the increase of infected cells, formation of immune complexes, and complement pathway activation, which lead to a cross-reaction of viral antigens with epithelial cells with platelets with subsequent endothelial dysfunction and bleeds. The first description of Evans syndrome was made in 1951 by Robert Evans. This syndrome is characterized by the combination of autoimmune hemolytic anemia, immune thrombocytopenia, and, less common/usual, immune neutropenia. This disease’s etiology is unknown, and the dysregulation of the immune system is among its possibilities. Here, we present the case of an unusual hematological and immunological complication of a patient who developed Evans syndrome during severe dengue, taking into account the concomitantly limited literature available for these two diseases, the need for a broader diagnostic approach, multidisciplinary intervention, and a more complex therapeutic approach.http://dx.doi.org/10.1155/2021/8635585 |
| spellingShingle | Ivan Jose Ardila Gomez Pilar Pérez López Mónika Rocío Hernández Carreño Juan Camilo Barrios Torres Dengue Infection and Its Relationship with Evans Syndrome: A Pediatric Case Case Reports in Medicine |
| title | Dengue Infection and Its Relationship with Evans Syndrome: A Pediatric Case |
| title_full | Dengue Infection and Its Relationship with Evans Syndrome: A Pediatric Case |
| title_fullStr | Dengue Infection and Its Relationship with Evans Syndrome: A Pediatric Case |
| title_full_unstemmed | Dengue Infection and Its Relationship with Evans Syndrome: A Pediatric Case |
| title_short | Dengue Infection and Its Relationship with Evans Syndrome: A Pediatric Case |
| title_sort | dengue infection and its relationship with evans syndrome a pediatric case |
| url | http://dx.doi.org/10.1155/2021/8635585 |
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