Juvenile Systemic Lupus Erithemathosus And Dengue Fever: A Case Report

Abstract

The clinical management of patients with systemic lupus erythematosus in emergency situations requires a thorough understanding of the clinical features and complications associated with this condition. The objective of this study is to report a clinical case of an individual with systemic lupus erythematosus undergoing treatment with azathioprine associated with dengue virus infection and severe clinical manifestations. The 27-year-old male patient developed fever, myalgia, and diarrhea eight days before admission, was admitted to the emergency room of a private hospital in São Paulo with clinical worsening associated with hypotension and drowsiness, and a sepsis protocol was opened, as evidenced in the initial laboratory tests of acute renal failure Kdigo III, hydroelectrolyte disorders, blood dyscrasias, pancytopenia, antibiotic therapy for septic shock, abdominal focus in the first hour, use of vasopressor drugs, and admitted to an intensive care bed. During hospitalization, a patient diagnosed with group D dengue and active systemic lupus erythematosus, presenting renal dysfunction requiring renal replacement therapy, liver failure, collection secondary to dengue virus infection, necrotizing pancreatitis, blood dyscrasias, respiratory failure, and alveolar hemorrhage secondary to capillaritis due to dengue or systemic lupus erythematosus, treated with broad-spectrum antibiotics, human immunoglobulin, corticosteroid therapy, however, despite all the therapeutic arsenal and advanced support, the patient progresses to death after 42 days of hospitalization. These situations pose significant challenges in the management of medical emergencies and endemic diseases, and therefore require a comprehensive understanding to ensure appropriate treatment and improved clinical outcomes.