Vaso-occlusive crisis in a sickle cell patient after transfusion-transmitted dengue infection

Author(s):Show less -

Santos, Flavia L. S. ^[1] ; Slavov, Svetoslav N. ^[1] ; Bezerra, Rafael S. ^[1] ; Santos, Elaine V. ^[1] ; Silva-Pinto, Ana C. ^[1] ; Morais, Ana L. L. ^[1] ; Sa, Mariana B. ^[2] ; Ubiali, Eugenia M. A. ^[1] ; De Santis, Gil C. ^[1] ; Covas, Dimas T. ^{[3, 1]} ; Kashima, Simone ^[1]

Affiliation

^[1] Univ Sao Paulo, Fac Med Ribeirao Preto, Reg Blood Ctr Ribeirao Preto, Rua Tenente Catao Roxo 2501, BR-14051140 Ribeirao Preto, SP - Brazil

^[2] Hosp Estadual Ribeirao Preto, Ribeirao Preto - Brazil

^[3] Univ Sao Paulo, Ribeirao Preto Med Sch, Ribeirao Preto - Brazil

• Document type: Journal article
• Source: Transfusion; v. 60, n. 9 JUL 2020.
• Web of Science Citations: 0

Abstract

Case Report A 26-year-old woman with sickle cell disease (SCD) on chronic transfusion therapy complained of severe arthralgia, myalgia, abdominal pain, headache, and fever 24 hours after transfusion of a red blood cells (RBCs). Dengue virus (DENV) infection was suspected and the patient was hospitalized for clinical support and RBC transfusion, to lower the hemoglobin S to less than 30%. The patient \& apos;s clinical condition improved approximately 8 days after the onset of symptoms. Results DENV type 2 (DENV-2) TaqMan real-time polymerase chain reaction was negative in the patient's pretransfusion sample while the posttransfusion sample was positive (Ct, 27.8), suggesting a high viral load and an acute infection. To investigate DENV transfusion transmission (TT-DENV) the stored donor serum was tested and was also positive (Ct, 25.8). Molecular typing confirmed the presence of DENV-2. The phylogenetic analysis of the DENV-2 strains obtained from both donor and patient samples were classified as the Southeast Asia-American genotype (Genotype III) and demonstrated 100% genomic identity, indicating TT-DENV. Conclusion This is the first description of TT-DENV in a SCD patient. A presumed high viral load in the transfused RBC unit probably determined the early clinical manifestation. In endemic regions dengue fever should be considered as differential diagnosis in SCD patients with fever and acute pain crisis, mainly during DENV outbreaks. (AU)

• FAPESP's process: 16/15049-3 - Development and validation of multiplex molecular platform for confirmatry diagnosis of Zika virus infection and establishment of laboratory standards
• Grantee: Simone Kashima Haddad
• Support Opportunities: Research Grants - Research in Public Policies for the National Health Care System (PP-SUS)
• FAPESP's process: 14/50947-7 - INCT 2014: in Stem Cell and Cell Therapy
• Grantee: Dimas Tadeu Covas
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 13/08135-2 - CTC - Center for Cell-Based Therapy
• Grantee: Dimas Tadeu Covas
• Support Opportunities: Research Grants - Research, Innovation and Dissemination Centers - RIDC