Dengue shock syndrome in sickle cell disease precipitating sickle cell hepatopathy: a case report

Abstract

Sickle cell disease (SCD) is a known risk factor for the development of severe dengue, however, literature documenting dengue in SCD is scarce. Dengue fever further triggers the sickling process in a patient with SCD by augmenting endothelial dysfunction, the main identifiable cause behind organ dysfunction. Hepatic involvement in SCD due to enhanced sickling can be in the form of acute viral hepatitis, cholecystitis, acute sickle hepatic crisis, and more severe sickle cell intrahepatic cholestasis (SCIC). Initially starting as an acute sickle hepatic crisis, SCIC progresses to striking jaundice, enhanced bleeding tendency coupled with mostly renal failure. We report a rare case of a female, native of Chhattisgarh with SCD and dengue shock syndrome who had fatal hepatic complications resulting from accelerated severe endothelial dysfunction due to concurrent illnesses.

Keywords

• sickle cell disease
• dengue infection
• dengue shock syndrome
• acute hepatic failure
• sickle cell hepatopathy