A Rare Case of Expanded Dengue, Evans Syndrome, Hellp Syndrome & Multiorgan Dysfunction

Dengue virus infection is being recognised to manifest with various systemic impairments. WHO has coined ‘EXPANDED DENGUE’ to denote such complications and atypical presentations. Here we present a case of Dengue who presented with PUO, bleeding, pain abdomen, vomiting and itching. She was noted to have fever, tachycardia, anaemia, thrombocytopenia, deranged liver function, acute pancreatitis, urinary abnormalities, rhinorrhea and pruritus. Her hospitalisation period was a stormy one posing both diagnostic and therapeutic problem. While recovering she exhibited neutropenia suggesting concomitant Evans syndrome. The different haematological and biochemical parameters also mimic that of HELLP syndrome.