Expanded Dengue Syndrome with Hemolytic Anemia: A Case Report

  • Gembong Satria Mahardhika Internship Doctor, Dharma Yadnya General Hospital, Denpasar, Bali, Indonesia.
  • Theodore Dharma Tedjamartono Internship Doctor, Dharma Yadnya General Hospital, Denpasar, Bali, Indonesia.
  • I Putu Denny Mahendra Department of Internal Medicine, Dharma Yadnya General Hospital, Denpasar, Bali, Indonesia.
Keywords: Dengue Hemorrhagic Fever, Anemia, Thrombocytopenia, Expanded Dengue Syndrome.


Introduction: Expanded Dengue Syndrome is an atypical manifestation of dengue hemorrhagic fever with compliciation of other organs such as the liver, spleen, and kidney. Haemolytic anemia is a rare complication that can occur in dengue haemorrhagic fever and the case has not been widely reported.

Patient and methods: This case report will discuss a 45-year-old man who presented with severe dengue haemorrhagic fever with atypical manifestations to the other systems such as haematology, hepatology, nephrology, and gastrointestinal problems.

Results: The patient was diagnosed with dengue hemorrhagic fever with the positive result of NS-1 antigen, IgG, and IgM dengue. Patient was diagnosed with severe anemia in conjunction with dengue infection. Examination of the peripheral blood smear, reticulocytes, and LDH was done with the result is haemolytic anemia. Coombs test was found negative. Transfusions of Packed Red Cells and Thrombocytes Concentrate were given as a treatment of severe anemia and thrombocytopenia. Patient recovered without further complications and was discharged home.

Conclusion: The condition of hemolytic anemia in EDS is a rare condition and should be aware of. Further examination in dengue hemorrhagic fever patients with severe anemia should be considered with the presence of hemolytic anemia.