Haemophagocytic lympohistiocytosis: a rare manifestation of dengue fever

Rosmonaliza AWANG ASLI ¹, Muhamad Arif ABDULLAH ¹, Pemasari Upali TELISINGHE ², Vui Heng CHONG ¹

¹ Department of Medicine and ² Department of Pathology, RIPAS Hospital, Bandar Seri Begawan, Brunei Darussalam

ABSTRACT

Haemophagocytic lymphohistiocytosis (HLH) or haemophagocytic syndrome is a rare disorder that is associated with high mortality. Manifestations are often non-specific, mimicking many common conditions that include infections, autoimmune disease and even neoplasms. It is characterised by cytopenia, hepato-splenomegaly, hyperferritinemia, hypertriglyceridemia, and haemophagocytosis. The underlying pathogenesis is not completely known but is believed to be due to activated but ineffective host immune responses in susceptible patients after external trigger such as virus infections. Associations with other micro-organisms have also been reported. We report a case of HLH that was associated with dengue fever, an infection that is still endemic in many parts of the world.

Keywords: Haemophagocytosis, dengue infection, leucopaenia, anaemia

Correspondence author: R AWANG ASLI, Division of Infectious Disease, Department of Medicine, RIPAS Hospital, Bandar Seri Begawan BA 1710, Brunei Darussalam.

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email: rozi8286@gmail.com

Brunei Int Med J. 2013; 9 (5): 334-337