Severe dengue with platelet membrane glycoprotein antibody positive: report of 1 case

Abstract

Abstract: Objective To understand the clinical features of severe dengue with platelet membrane glycoprotein antibody positive and to explore its clinical management. Methods The clinical data and treatment of a severe dengue fever case with positive platelet membrane glycoprotein antibody in our hospital were retrospectively analyzed. Results The 21-year old, male patient,with acute onset manifested one-day fever and systemic rash. 6 days after fever, the patient was found gingival bleeding and urine bleeding. The regular blood examination showed that HGB：151.00g/L, PLT：2.00×10⁹/L, HCT：43.3%. After infusion of platelets, platelet recovery was not obvious and the index of platelet dropped to 1.00×10⁹/L. Dengue fever antibody was found positive.The main treatment measures including absolute bed, acid inhibition and other comprehensive treatment. Platelet relative antibody were examined. The antibody GPIIb/Ⅲa was positive. Given the gamma globulin and hormone, the patient's platelets rebounded, the bleeding symptoms remission, and the platelets rebounded. Conclusion Severe Dengue could lead to severe bleeding.Platelet relative antibodies should be checked. Gamma globulin and glucocorticoid might be helpful. The timing of usage and doseneed further study.

Key words: Severe Dengue, Platelet membrane glycoprotein antibody, Case report

LIN Lu-ping, FAN Hui-min, LI Yue-ping, CHEN Xie-jie, ZHAO Ling-zhai, YAO Xi-an, YE Xin, DENG Jing, TAN Xing-hua, ZHANG Fu-chun. Severe dengue with platelet membrane glycoprotein antibody positive: report of 1 case[J]. Electronic Journal of Emerging Infectious Diseases, 2018, 3(2): 95-97.

References

[1] BHATTS, GETHING PW, BRADY OJ, et al.The global distribution and burden of dengue[J].Nature, 2013, 496(7446): 504-506.
[2] DIAZ-QULJANO FA, VILIAR-CENTENO LA, MARTINEZ-VEGA RA.Predictors ofspontaneous bleeding in patients with acute febrile syndrome from a dengue endemic area[J].Clin Virol,2010,49(1):11-15.
[3] 洪文昕,王建,邱爽,等.121例成人重症登革热的临床特征及救治体会[J]. 中山大学学报(医学科学版),2016,37(3):334-336.
[4] DASH AP, BHATIA R, KARAL NI.Dengue in South East Asia: an appraisal of case management and vector control[J].Dengue Bulllentin, 2013, 36:1-3.
[5] 应若素,王建,洪文昕,等. 广东省2014年登革热暴发流行的临床和实验室特点[J]. 中华传染病杂志,2014,32(12):720-723.
[6] SRIKIATKHACHORN A,GREEN S.Markers of dengue disease severity[J].Curr Trop Microbiol Immunol,2010,338:67-82.
[7] LIN CF,LEI HY,LIU CC, et al.Generation of IgM anti—platelet autoantibody in dengue patients[J].J Med Virol,200l,63(2):143-149.
[8] 0ISHI K,IN0UES,CINCO MT, et al. Correlation between increased platelet-associated IgG and thrombocytopenia in secondary dengue virus infections[J]. J Med Virol, 2003, 7l(2):259-264
[9] 杨方集,吴元凯,陈淑如,等.登革热患者血小板减少与血小板膜糖蛋白特异性抗体相关[J]. 中山大学学报(医学科学版),2016,37(3):326-332.
[10] SRIDHARAN A,CHEN Q,TANG KF, et al.Inhibition of megakaryocyte development in the bone marrow underlies dengue virus-induced thrombocytopenia in humanized mice[J].J Virol,2013,87(21):11648-11658.
[11] KRISHNAMURTI C,PEAT RA,CUTTING MA, et al.Platelet adhesion to dengue-2 virus-infected endothelial cells[J].Am J Trop Med Hyg,2002,66(4):435-441.
[12] SUN DS,KING CC, HUANG HS, et al.Antiplatelet autoantibodies elicited by dengue virus non-structural protein 1 cause thrombocytopenia and mortality in mice[J].J Thromb Haemost,2007,5(11):2291-2299.
[13] CHEN MC,UN CH.Deletion of the C-terminal region of dengue virus nonstructural protein 1(NSl)abolishes anti-NSl-mediated platelet dysfunction and bleeding tendency[J].J Immunol,2009,183(3):1797-1803.
[14] AZEREDO ELD,MONTEIR0 RQ,PINT0 D0.Thrombocytopenia in dengue: interrela-tionship between virus and the imbalance between coagulation and fibrinolysis and inflammatory mediators[J].Mediators Inflamm, 2015, 2015(4):1-16.
[15] LIN CF,WAN SW,CHENG HJ,et al.Autoimmune pathogenesis in dengue virus infection[J]. Viral Immunol, 2006, 19(2): 127-132.
[16] PRASHANTHA B,VARUN S,SHARAT D, et al.Prophyactic platelet transfusion in stable dengue fever patients:is it really necessary[J] Indian J Hematol Blood Transfus, 2014, 30(2):126-129.
[17] DAVID C,SOPHIA A, SHARIFA F S, et al.Prophylactic platelet transfusion plus supportive care versus supportive care alone in adults and thrombocytopenis: a multicentre, open-label, randomized, superiority trial[J].J Lancet,,2017,389:1611-1618.
[18] 中华人民共和国国家卫生和计划生育委员会,登革热诊疗指南(2014年第2版),中国医药科学,2014(4):221-224.
[19] 中华医学会儿科学分会血液学组.儿童原发性免疫性血小板减少症诊疗建议[J].中华儿科杂志,2013,5l(5):382-384.
[20] DE CAsTR0 RA,DE CASTR0 JA,BAREZ MY,et al. Thrombocytopenia associated with dengue hemorrhagic fever responds to intravenous administration of anti-D Rh(o)-D)immune-globulin[J].AmJ Trop Med Hyg,2007,76(4):737-742.
[21] DIMAAN0 EM,SAIT0 M,HONDA S, et al. Lack of efficacy of high-dose intravenous immunoglobulin treatment of severe thrombocytopenia in patients with secondary dengue virus infection[J].Am J Trop Med Hyg,2007,77(6):1135-1138.