Clinical and laboratorial profiles of dengue virus infection in kidney transplant recipients: Report of a single center

Author(s)

Maximina Fernandes-Charpiot, Ida Maria ^[1] ; Estofolete, Cassia Fernanda ^[2] ; Caldas, Heloisa Cristina ^[1] ; de Souza, Gabriela Rodrigues ^[1] ; Martins Alves da Silva, Rita de Cassia ^[1] ; Sperto Ferreira Baptista, Maria Alice ^[1] ; Nogueira, Mauricio Lacerda ^[2] ; Abbud-Filho, Mario ^{[1, 3]}

Affiliation

^[1] FAMERP Hosp Base Sao Jose do Rio Preto, Fac Med Sao Jose do Rio Preto, Kidney Transplant Unit, Sao Jose Do Rio Preto - Brazil

^[2] FAMERP, Fac Med Sao Jose do Rio Preto, Lab Res Virol, Sao Jose Do Rio Preto - Brazil

^[3] Inst Urol & Nefrol, Sao Jose Do Rio Preto - Brazil

• Document type: Journal article
• Source: PLoS One; v. 14, n. 10 OCT 30 2019.
• Web of Science Citations: 0

Abstract

Dengue infection (DI) is the most important arboviral infection in the world. The majority of immunocompetent patients will have asymptomatic or mild infections, but the degree of dengue severity in kidney transplant recipients (KTx) is unknown. In this study, we report the clinical profile and outcomes of 39 dengue cases in KTx. From a total of 1,186 KTx outpatients in follow-up we reviewed clinical and laboratory records of 60 (5%) patients admitted with suspected DI initially screened by NS-1, IgM, and when possible, multiplex nested PCR. The prevalence of DI in KTx was 3% (39/1,118), with symptoms leading to hospital admission being fever, myalgia, malaise, and headache. Laboratory tests showed leucopenia, thrombocytopenia, and liver enzyme elevation. DI was confirmed by positivity of NS-1 (33%), IgM (69%), and/or RT-PCR (59%). Twenty-three patients (59%) had dengue with warning signs, and 15% had severe dengue, 2 of them with a fatal course. Acute graft dysfunction occurred in 59% (mean nadir serum creatinine: 2.9 2.6mg/dL), 4 of them requiring dialysis. CMV coinfection diagnosed in 19% of the cases and patients was associated with worse clinical presentation. Our results suggest that KTx with DI presented initial physical and laboratorial profile similar to the general population. However, DI in KTx seems to have a higher risk for graft dysfunction, severe dengue, and death. Because CMV coinfection aggravates the DI clinical presentation and recovery, it must be evaluated in all cases. (AU)

• FAPESP's process: 13/21719-3 - Epidemiological study of dengue (serotypes1-4) in a cohort of São José do Rio Preto, São Paulo, Brazil, during 2014-2018
• Grantee: Maurício Lacerda Nogueira
• Support Opportunities: Research Projects - Thematic Grants