HEMOPHAGOCYTOSIS: AN UNUSUAL COMPLICATION OF CLASSICAL DENGUE FEVER WITH ACUTE LIVER FAILURE.

Abstract

Dengue is a vector-borne disease caused by dengue virus. It has a diverse presentation and usually presents as an asymptomatic, self-limiting disease. Among the unusual presentations, hepatic dysfunction is well reported. Complications of dengue fever can be protean and life-threatening. Dengue may cause bone marrow suppression leading to thrombocytopenia, leukopenia and anemia in acute phase of illness; and increased hematocrit due to capillary leakage, but these changes are self-limiting and require no further investigations and specic treatment. Dengue associated Hemophagocytic lymphohistiocytosis (HLH) is a rare complication of Dengue haemorrhagic fever or Dengue shock syndrome. Diagnosis of secondary HLH (sHLH) due to dengue is usually challenging and delayed as initial clinical symptoms mimic sepsis and systemic inammatory response syndrome (SIRS). Delayed or no treatment of sHLH has a poor outcome. We present an unusual case of classical dengue fever presented as Acute liver failure (ALF) with encephalopathy, later complicated by sHLH.