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Table of Contents   
LETTER TO THE EDITOR  
Year : 2017  |  Volume : 10  |  Issue : 2  |  Page : 465-466
Severe eosinophilia in dengue patient: An interesting case study


1 KMT Primary Care Center, Bangkok, Thailand
2 Hainan Medical University, Haikou, Hainan, China

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Date of Web Publication22-Jun-2017
 

How to cite this article:
Yasri S, Wiwanitkit V. Severe eosinophilia in dengue patient: An interesting case study. Ann Trop Med Public Health 2017;10:465-6

How to cite this URL:
Yasri S, Wiwanitkit V. Severe eosinophilia in dengue patient: An interesting case study. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Aug 23];10:465-6. Available from: http://www.atmph.org/text.asp?2017/10/2/465/208714
Dear Sir,

The dengue infection is common in Southeast Asia and South Asia. There are many cases each year. The clinical features of this infection are acute febrile illness with decreased platelet count.[1] Those clinical problems are usually observed and usually used as a preliminary clinical diagnosis.[1] However, it should be noted that sometimes there can be other occulted hematological disease that concurrently occur with dengue. Here, the authors report a case study of severe eosinophilia in dengue patient. The case is of a 45-year-old male patient who presented to the physician with acute febrile illness and myalgia. The workup showed thrombocytopenia (platelet = 95,000/μL) and positive dengue antigen test. However, there was an interesting observation of high eosoniophil percentage (27.5%). On follow-up, the platelet count was seen to have improved to normal but the eosinophilia was still observed to be high. This case was asked to consult with the hematologist. After one month of following up, blast cell could be seen in blood smear of this patient and the final diagnosis was acute lymphoblastic leukemia. In fact, the hypereosinophilic syndrome is a usually forgotten problem.[2] It can be seen in routine blood examination and it is considered as a high risk for leukemia. According to the report by Anderson et al., severe cases of unexplained hypereosinophilia ended up with leukemia.[3] It should be noted that eosinophilic presentation can be an early warning of acute lymphoblastic leukemia.[4] In the present study, this finding was concurrently observed when the patient had dengue. If the physician-in-charge had no concern for an unexplained severe eosinophilia, the case could be easily missed.

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   References Top

1.
Wiwanitkit V. Dengue fever: Diagnosis and treatment. Expert Rev Anti Infect Ther 2010;8:841-5.  Back to cited text no. 1
[PUBMED]    
2.
Curtis C, Ogbogu P. Hypereosinophilic syndrome. Clin Rev Allergy Immunol 2015. [Epub ahead of print].  Back to cited text no. 2
    
3.
Andersen CL, Siersma VD, Hasselbalch HC, Lindegaard H, Vestergaard H, Felding P, et al. Eosinophilia in routine blood samples and the subsequent risk of hematological malignancies and death. Am J Hematol 2013;88:843-7.   Back to cited text no. 3
[PUBMED]    
4.
Rezamand A, Ghorashi Z, Ghorashi S, Nezami N. Eosinophilic presentation of acute lymphoblastic leukemia. Am J Case Rep 2013;14:143-6.  Back to cited text no. 4
[PUBMED]    

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Correspondence Address:
Sora Yasri
KMT Primary Care Center, Bangkok
Thailand
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.208714

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