Thrombotic microangiopathy associated with arboviral infection: Report of 3 cases

by Jos é Luiz Coelho Júnior, Karla Cristina Petruccelli Israel, Carlos Eduardo Everton Machado, Monique Pereira Rêgo Muniz, Giuseppe Cesare Gatto, Flávio Henrique Soares Barros, Kaile de Araújo Cunha, Marcus Vinícius Guimarães de Lacerda, Precil Diego Miranda de Menezes Neves, Gyl Eanes Barros Silva Dengue fever and chikungunya are viral diseases that have spread rapidly throughout the world in recent decades. The occurrence of complications is well known, including prerenal acute kidney injury (AKI), which is usually thought to be caused by dehydration and fluid loss. Thrombotic microangiopa thy (TMA) is an uncommon aggravation of dengue fever and chikungunya, with only a few cases described in the medical literature. The aim of this study is to present 3 cases of TMA associated with arboviral infection. Three patients with clinical history, laboratory test, and kidney biopsy results co mpatible with TMA were selected for the study, 2 of whom had a serological diagnosis of dengue fever and 1 of chikungunya. The 3 patients were followed up at the Federal University of Maranhão Hospital’s Nephrology Service in 2018. A targeted gene panel sequencing (TGPS) plus multiple to atypical hemolytic uremic syndrome (aHUS) multiplex ligation–dependent probe amplification (MLPA) was performed in 2 of the patients and revealed in the patient 1 a heterozygous pathogenic variant in the geneTHBD, as well as heterozygous deletions inCFH,CFHR1, andCFHR3. In the patient 2, there we...
Source: PLoS Neglected Tropical Diseases - Category: Tropical Medicine Authors: Source Type: research