Microbiology Research & Infectious Diseases
When Dengue Defies Expectations: Unmasking Immune Thrombocytopenic Purpura as a part of Expanded Dengue Syndrome
Authors: Richmond Ronald Gomes*
Abstract
Dengue is a prevalent arthropod-borne viral disease in tropical and subtropical areas of the globe. Dengue clinical manifestations include asymptomatic infections; undifferentiated fever; dengue fever, which is characterized by fever, headache, retro orbital pain, myalgia, and arthralgia; and a severe form of the disease denominated dengue hemorrhagic fever/dengue shock syndrome, characterized by hemoconcentration, thrombocytopenia, and bleeding tendency. However, atypical manifestations, such as liver, central nervous system, respiratory, lymphoreticular and cardiac involvement, have been increasingly reported called expanded dengue syndrome. Thrombocytopenia usually gets better and platelet count normalizes by day 10 of fever. Chronic thrombocytopenia is not a feature of dengue fever. Immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by low platelet count and skin-mucosal bleeding. It commonly affects adult female in an idiopathic and chronic manner. Thrombocytopenia associated with dengue viral infection seems to result in both from a reduction in the production of platelets from megakaryocytes and immune mediated destruction of platelets. Here we report a 30-year-old Bangladeshi lady who having persistent thrombocytopenia beyond two weeks of dengue illness who responded to steroid therapy on the line of immune thrombocytopenia after ruling out other common causes of thrombocytopenia. The report also highlights the value of monitoring platelet counts in post-recovery phase to ensure they have normalized
Citation: Richmond R Gomes. When Dengue Defies Expectations: Unmasking Immune Thrombocytopenic Purpura as a part of Expanded Dengue Syndrome. Microbiol Res Infec Dis. 2026; 1(1), 01-06.