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Intravenous immunoglobulin therapy for dengue capillary leak syndrome in a renal allograft recipient
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Intravenous immunoglobulin therapy for dengue capillary leak syndrome in a renal allograft recipient
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Journal Article
Intravenous immunoglobulin therapy for dengue capillary leak syndrome in a renal allograft recipient
2018
Overview
A 45-year-old man presented 4 months after ABOi renal transplantation with febrile illness and bicytopenia necessitating cessation of mycophenolate mofetil. Dengue non-structural protein 1 antigen (NS1 Ag) test was positive. Lowest total leucocyte count was 3.1×109/L and platelet count was 14×109/L. As fever subsided, patient became tachypneic with abdominal distention and hypotension. Ultrasonographic evaluation revealed ascites, gall bladder wall oedema and bilateral pleural effusion consistent with dengue capillary leak syndrome. He developed massive ascites with abrupt weight gain of 4 kg within 24 hours and worsening renal dysfunction. Patient was deteriorating rapidly in spite of adequate supportive care and we gave a trial of intravenous immunoglobulin (0.5 g/kg/day) for 5 days. Patient improved from day 2, and by day 3, he became haemodynamically stable and recovered completely. Patient was stable at discharge and is on regular follow-up.
Publisher
BMJ Publishing Group Ltd,BMJ Publishing Group LTD,BMJ Publishing Group
Subject
/ Ascites
/ Capillary Leak Syndrome - drug therapy
/ Capillary Leak Syndrome - etiology
/ Edema
/ Fluids
/ Humans
/ Immunoglobulins, Intravenous - administration & dosage
/ immunological products and vaccines
/ Kidney Transplantation - adverse effects
/ Male
/ Novel treatment (new drug/intervention; established drug/procedure in new situation)
/ Patients
/ Severe Dengue - complications
