Hemoadsorption Therapy for Expanded Dengue Syndrome Patients : A Case Series Study

Abstract

Background: Dengue is a tropical infection transmitted by mosquitoes. It manifests expanded spectrum of diseases from mild to severe form.  Pathogenesis of denguecauses thrombocytopenia by immune destructionwhich may cause bleeding  manifestationand also a high viral load causes activation of T cell that make "storm" of inflammatory cytokines, leading to huge plasma leakage as a result patient develop haemoconcentration and shock.  Expanded dengue syndrome is a rare category of dengue infection that involves multiple organs of the body and bears a fatal outcome.  Hemoadsorption is an extra-corporeal blood purification method used to reduce excess inflammatory mediators from blood. It is a haemo-adsorption procedure that was  approved as an adjunct therapy for the management of  sepsis and other high inflammatory conditions.

Case Presentation: We present three (3) cases of  Expanded Dengue Syndrome along with fatal complications that were managed by hemoadsorption therapy. All the patientswere treated in the intensive care unit (As per national guideline of Dengue) with fluids, antibiotics, oxygen supplement,non-invasive ventilation etc. when patient’s conditiondid not improved after using all of these interventions,hemoadsorption therapy was introduced. After application of hemoadsorption therapy, all the patients were fully recovered without any residual disability. They were discharged on the 12th, 10th and 8th days of hospital stay respectively. when there is evidence of multi organ involvementin dengue fever, the disease burden is increased and treatment with such manifestations gets very challenging.

Conclusion: Hemoadsorption therapy can be an effective adjuncttherapy for expanded dengue syndrome patients.

JCMCTA 2026 ; 37 (1) : 192-197