Albuquerque Polianna L M M, Silva Júnior Geraldo B, Diógenes Saulo S, Silva Herivaldo F
Division of Internal Medicine, Hospital Geral César Cals, and School of Medicine, Universidade Estadual do Ceará, Fortaleza, Ceará, Brazil.
Travel Med Infect Dis. 2009 Mar;7(2):118-20. doi: 10.1016/j.tmaid.2009.01.001. Epub 2009 Feb 7.
Aplastic anemia is a medullary insufficiency secondary to the complete or partial disappearance of hematopoietic tissue without abnormal cellular proliferation. This is a rare complication of infections, such as dengue hemorrhagic fever. A 15-year-old girl was admitted with anemia, bleeding from the gums, petechiae and fever. Laboratory tests at the time of admission showed: Hemoglobin 4.8 g/dl; Hematocrit 13.4%; white blood count 2240/microl and platelets 11,500/microl. Dengue virus IgM antibodies were found. A bone marrow aspirate and biopsy showed severe aplastic anemia. Treatment with intravenous immunoglobulin and methylprednisolone was started. The patient had a favorable outcome. She was then given long-term treatment with cyclosporin. She is now in remission, without any symptoms. Dengue can induce aplastic anemia through direct bone marrow invasion. This is a rare complication which must be identified early. Immunosuppressive therapy can induce complete remission.
再生障碍性贫血是一种继发于造血组织完全或部分消失且无异常细胞增殖的骨髓功能不全。这是感染（如登革出血热）的一种罕见并发症。一名15岁女孩因贫血、牙龈出血、瘀点和发热入院。入院时实验室检查显示：血红蛋白4.8g/dl；血细胞比容13.4%；白细胞计数2240/微升，血小板11500/微升。发现登革病毒IgM抗体。骨髓穿刺和活检显示严重再生障碍性贫血。开始用静脉注射免疫球蛋白和甲泼尼龙治疗。患者预后良好。随后给予环孢素长期治疗。她现在处于缓解期，没有任何症状。登革热可通过直接侵犯骨髓诱发再生障碍性贫血。这是一种罕见并发症，必须早期识别。免疫抑制治疗可诱导完全缓解。
