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Intravenous immunoglobulin for severe thrombocytopenia in secondary dengue
  1. Vinod Kumar,
  2. Kartik Gupta,
  3. Manish Soneja,
  4. Ashutosh Biswas
  1. Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
  1. Correspondence to Dr Manish Soneja, manishsoneja{at}


A 30-year-old woman with severe dengue presented on the sixth day of her illness with life-threatening thrombocytopenia, refractory to multiple platelet transfusions. Dengue IgM antibody and the non-structural-1 antigen tests as of day 3 were negative. The IgG antibody against the same was positive, suggesting a past episode of dengue. Since she had a history of menorrhagia prior to the current illness, a working diagnosis of idiopathic thrombocytopenic purpura was made, for which intravenous immunoglobulin (IVIg) was administered that led to a rapid rise in the platelet count with no adverse events. Subsequently, dengue IgM antibody repeated on day 6 came back positive, confirming dengue. This case report re-emphasises the potential use of IVIg in patients with severe thrombocytopenia in dengue.

  • infections
  • haematology (incl blood transfusion)
  • therapeutic indications

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  • Contributors VK: report writing, data collection and patient management. KG: review of literature and data collection. MS: patient management decisions and report writing and finalisation. AB: patient management decisions and guidance.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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