Case report reveals Budd-Chiari syndrome and sensory polyneuropathy in acute dengue infection, highlighting potential transient thrombotic complications despite low platelet counts.
Key Points
To document a rare presentation of acute dengue infection complicated by hepatic vein thrombosis and peripheral nerve involvement.
Evaluated a 22-year-old male presenting with fever, abdominal pain, and dehydration using dengue IgM serology, liver function tests, and thrombophilia panels.
Administered supportive therapy and anticoagulation with low-molecular-weight heparin followed by warfarin, re-evaluating thrombophilia markers after 6 months.
Imaging confirmed hepatic vein thrombosis, inferior vena cava narrowing, and caudate lobe hypertrophy consistent with Budd-Chiari syndrome, alongside sensory polyneuropathy on electrodiagnostic testing.
Initial laboratory work revealed severe transient deficiencies in protein C, protein S, and antithrombin III that fully normalized at 6 months, confirming an acquired etiology.
Anticoagulation led to complete recanalization of the hepatic veins, resolution of ascites, and normalization of liver enzymes without hemorrhagic events despite baseline thrombocytopenia (104,000/mm³).