Dengue Fever: A Harmful Disease in Patients with Thrombocytopenia?

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Abstract
Dengue fever (DF) is the most prevalent and expanding arboviral disease in humans, and its incidence is increasing. Transmitted by Aedes mosquitoes and epidemic in most tropical areas, the disease may have a high attack rate among people of any age, regardless of whether they are residents of or travelers to areas of endemicity. Neither a specific treatment nor a vaccine is presently available [1, 2]. The most common presentation (in >90% of cases) is that of “classic” DF, an acute self-limited disease that causes a high fever, musculoskeletal pain, and rash. On occasion, DF with severe bleeding or shock, known as “dengue hemorrhagic fever” (DHF), may occur, especially in children, and it can be fatal [2]. DF is caused by 4 distinct viruses that belong to the Flaviviridae family (dengue virus serotypes [DEN] 1–4), all of which cause a clinically identical disease. Because these viruses induce only partial cross-immunity, a first episode of the disease, or “primary DF,” may be followed by “secondary DF,” a sequence considered to enhance clinical severity and favor DHF [1]. Thrombocytopenia (TCP) of moderate degree is a usual finding associated with both forms of the disease [3]. We describe 2 adults from an area of endemicity who developed DF while they had chronic underlying autoimmune TCP.

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