ABSTRACT
Thrombotic microangiopathy is a pathological condition comprised of microvascular thrombosis involving any body organ leading to thrombocytopenia, coombs-negative hemolytic anemia, and end-organ damage. The clinical presentation of the case shows typical hemolytic uremic syndrome, however, lab reports show atypical hemolytic uremic syndrome (low C3). Pain abdomen and loose stool with some signs of dehydration were initial presentations. Early initiation of renal replacement therapy and management of dehydration was done. Simple diarrhea can also manifest as acute kidney injury with the hemolytic uremic syndrome. Hence we should keep hemolytic uremic syndrome as the differential diagnosis of diarrhea. Irrespective of lab parameters, early management in line with the typical hemolytic uremic syndrome should be done for better outcomes. Keywords: anemia; case reports; dehydration; renal replacement therapy.
Subject(s)
Acute Kidney Injury , Atypical Hemolytic Uremic Syndrome , Thrombotic Microangiopathies , Humans , Dehydration/complications , Atypical Hemolytic Uremic Syndrome/complications , Atypical Hemolytic Uremic Syndrome/diagnosis , Atypical Hemolytic Uremic Syndrome/therapy , Thrombotic Microangiopathies/diagnosis , Thrombotic Microangiopathies/drug therapy , Thrombotic Microangiopathies/etiology , Acute Kidney Injury/diagnosis , Acute Kidney Injury/etiology , Acute Kidney Injury/therapy , Diarrhea/etiologyABSTRACT
Dengue is one of the most common viral infections affecting the general population in endemic areas annually. However, it is barely reported in newborns owing to a widespread belief that they are protected from severe viral infections in the first six months of life by the presence of maternal antibodies. Here we present a case of a 23-day-old male infant born to primigravida with dengue fever with the post-natal transmission of infection. He presented with complaints of fever for three days. On general examination, red-coloured pinpoint macular rashes were observed bilaterally on lower limbs. No significant findings were present on systemic examination. On routine sepsis workup, thrombocytopenia was present. Acknowledging the endemicity and expanding dengue cases, NS1 antigen and antibody IgM and IgG of the baby were tested which came positive for antigen and IgM antibody. Even so, the mother was asymptomatic with NS1 antigen, IgG and IgM antibodies negative with a normal range of platelet count. Keywords: case report; dengue fever; neonates, Nepal.
