Fatal Outcome in a Pregnant Woman with HELLP Syndrome and Dengue

Abstract

Hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome is a rare complication consisting of pregnancy-induced hypertension, hemolysis, elevated liver enzymes, and thrombocytopenia. Dengue, caused by an arbovirus, manifests with fever, thrombocytopenia, and hemorrhagic symptoms. We report a 26-year-old primigravida at 29 weeks of gestation from northern Peru with preeclampsia. During hospitalization, she developed fever, thrombocytopenia, and was diagnosed with severe dengue by a positive nonstructural protein 1 antigen test. Her condition worsened because of preeclampsia with signs of severity. She was admitted to the intensive care unit, and she did undergo a cesarean section. On the seventh day, she developed HELLP syndrome and multiple organ failure, culminating in her death on the ninth day. In endemic areas, it is important to consider clinical scenarios where the simultaneous manifestation of hypertensive disease and dengue may occur in the pregnant population, as timely diagnosis and appropriate management of both diseases are key to improve clinical outcomes.