Wegener’s granulomatosis with dengue fever: an unusual association

Re-examination of the risk of autoimmune diseases after dengue virus infection: A population-based cohort study

Previous studies suggested that dengue was associated with an increased risk of several autoimmune diseases. However, this association still needs to be explored due to the limitations of these studies. A population-based cohort study was conducted using national health databases in Taiwan and included 63,814 newly diagnosed, laboratory-confirmed dengue patients between 2002 and 2015 and 1:4 controls (n = 255,256) matched by age, sex, area of residence and symptom onset time. Multivariate Cox proportional hazard regression models were used to investigate the risk of autoimmune diseases after dengue infection. Dengue patients had a slightly higher risk of overall autoimmune diseases than non-dengue controls (aHR 1.16; P = 0.0002). Stratified analyses by specific autoimmune diseases showed that only autoimmune encephalomyelitis remained statistically significant after Bonferroni correction for multiple testing (aHR 2.72; P < 0.0001). Sixteen (0.025%) dengue patients and no (0%) controls developed autoimmune encephalomyelitis in the first month of follow-up (HR >9999, P < 0.0001), but the risk between groups was not significantly different thereafter. Contrary to previous studies, our findings showed that dengue was associated with an increased short-term risk of a rare complication, autoimmune encephalomyelitis, but not associated with other autoimmune diseases.

Dengue associated with severe cutaneous leukocytoclastic vasculitis and pericardial effusion: a case report

Dengue is a viral disease, caused by an arbovirus of the genus Flavivirus. In Brazil, its incidence rate is high with a broad clinical spectrum. This report discusses a rare case of dengue associated with cutaneous leukocytoclastic vasculitis and pericardial effusion with eminence of cardiac tamponade in a previously healthy patient with no comorbidities. The serology for dengue was positive and the histopathological analysis of the cutaneous lesions confirmed the diagnosis of leukocytoclastic vasculitis. After receiving treatment, the patient’s condition greatly improved.

Increased risk of autoimmune diseases in dengue patients: A population-based cohort study

OBJECTIVE

To investigate the risk of autoimmune diseases in dengue patients.

METHODS

We conducted a population-based cohort study by the Taiwan National Health Insurance Research Database, including a total of 12,506 newly diagnosed dengue patients and 112,554 control subjects between 2000 and 2010, matched by gender, age, income, urbanization, and comorbidities. Both cohorts were followed for a 3-year period to examine the incidence of autoimmune diseases. A Cox proportional hazards regression analysis was applied to calculate the risk of autoimmune diseases between both groups.

RESULTS

The dengue group showed an overall increased risk for 21 autoimmune diseases, with an adjusted hazard ratio (aHR) of 1.88 (95% confidence interval [CI], 1.49-2.37, p < 0.001). Compared with the control group, the dengue group had higher risks of Reiter's syndrome (aHR 14.03, 95 % CI 1.63-120.58), multiple sclerosis (aHR 11.57, 95 % CI 1.8-74.4), myasthenia gravis (aHR 5.35, 95 % CI 1.43-20.02), autoimmune encephalomyelitis (aHR 3.8, 95% CI 1.85-7.8), systemic vasculitis (aHR 3.7, 95 % CI 1.11-12.28), systemic lupus erythematosus (aHR 3.5, 95% CI 1.85-6.63), and primary adrenocortical insufficiency (aHR 2.05, 95% CI 1.25-3.35).

CONCLUSION

Dengue patients were associated with an increased risk of autoimmune diseases.