Overlap of dengue fever and HELLP syndrome in pregnancy: a complex clinical encounter

Authors

  • Hanish Garg Department of Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
  • Kabir Gupta Department of Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
  • F. N. U. Harsh Department of Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
  • Jay Gohri Department of Medicine, JSS Medical College, Mysore, Karnataka, India
  • Amrita Rathee Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20241580

Keywords:

Dengue fever, Arbovirus, HELLP syndrome, Thrombocytopenia

Abstract

Dengue fever is an arboviral infection caused by the bite of an infected Aedes mosquito, common in tropical areas, especially in India. It is characterized by fever, fatigue, malaise, joint pain, retrobulbar pain, abdominal pain, and thrombocytopenia. It is often complicated by bleeding manifestations like petechiae, bleeding gums, and blood in vomitus. Hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome is usually a complication of preeclampsia in pregnancy (elevated blood pressure after 20 weeks of gestation) and is characterized by hemolysis, elevated liver enzymes, and low platelet count. This is the case of a primigravida that presented at 32 weeks + 2 days of gestation with dengue fever in the background of HELLP syndrome. Significant overlap in the features of dengue fever and HELLP syndrome can lead to a delay in the diagnosis of HELLP syndrome and its management. This case highlights the importance of early recognition of HELLP syndrome in a dengue positive pregnant patient.

References

World Health Organization. WHO Vector-borne diseases. 2024. Available at: https://www.who. int/news-room/factsheets/detail/vector-borne-diseases. Accessed on 15 January 2024.

National Center for Vector Borne Diseases Control (NCVBDC). Dengue Situation in India. 2024. Available at: https://ncvbdc.mohfw.gov.in/index4. php?lang=1&level=0&linkid=431&lid=3715. Accessed on 17 January 2024.

Sibai BM. The HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets): much ado about nothing? Am J Obstet Gynecol. 1990;162(2):311-6.

Tayal A, Kabra SK, Lodha R. Management of Dengue: An Updated Review. Indian J Pediatr. 2023,90(2):168-77.

Haram K, Svendsen E, Abildgaard U. The HELLP syndrome: clinical issues and management. A Review. BMC Pregnancy Childbirth. 2009;9:8.

Pradeep AV, Rao S, Ramesh Kumar R. Partial HELLP syndrome with unilateral exudative retinal detachment treated conservatively. Saudi J Ophthalmol. 2014;28(4):329-31.

Sibai BM. Diagnosis, controversies, and management of the syndrome of hemolysis, elevated liver enzymes, and low platelet count. Obstet Gynecol. 2004;103(5):981-91.

Padden MO. HELLP syndrome: recognition and perinatal management. Am Fam Physician. 1999;60(3):829-36.

Patnaik R, Kulkarni S, Karan N. Dengue and HELLP: Beware of the Masquerade. Indian J Crit Care Med. 2022;26(5):639-40.

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Published

2024-05-31

How to Cite

Garg, H., Gupta, K., Harsh, F. N. U., Gohri, J., & Rathee, A. (2024). Overlap of dengue fever and HELLP syndrome in pregnancy: a complex clinical encounter. International Journal of Research in Medical Sciences, 12(6), 2154–2156. https://doi.org/10.18203/2320-6012.ijrms20241580

Issue

Section

Case Reports