Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 26 , ISSUE 5 ( May, 2022 ) > List of Articles


Dengue and HELLP: Beware of the Masquerade

Rohit Patnaik, Shruthi Kulkarni, Nupur Karan

Keywords : Cesarean section, Dengue fever, Fetomaternal outcome, HELLP syndrome, Obstetric ICU

Citation Information : Patnaik R, Kulkarni S, Karan N. Dengue and HELLP: Beware of the Masquerade. Indian J Crit Care Med 2022; 26 (5):639-640.

DOI: 10.5005/jp-journals-10071-24213

License: CC BY-NC 4.0

Published Online: 20-05-2022

Copyright Statement:  Copyright © 2022; The Author(s).


HELLP is a syndrome characterized by hemolysis, elevated liver enzymes, and low platelets. It is a rare complication of pregnancy and is usually associated with pre-eclampsia. However, 10–20% cases of HELLP can present without hypertension. Dengue fever is an arboviral-borne tropical illness that is characterized with fever, thrombocytopenia, and bleeding manifestations. We present a case of a primigravida with HELLP syndrome masquerading in the background of dengue fever. Unique features to this case report include delayed presentation of HELLP syndrome with normotension which can have overlapping features with dengue fever, especially in term pregnancy. This case highlights the need of strict vigilance in cases of dengue fever with pregnancy.

  1. Dengue guidelines for diagnosis, treatment, prevention and control. Geneva: World Health Organization, Special Programme for Research and Training in Tropical Diseases (TDR); 2009.
  2. Harde M, Bhadade R, deSouza R, Jhingan M. Thrombocytopenia in pregnancy nearing term: a clinical analysis. Indian J Crit Care Med 2019;23(11):503–508. DOI: 10.5005/jp-journals-10071-23277.
  3. Shastri PS, Taneja S. Dengue and other viral hemorrhagic fevers. Indian J Crit Care Med 2021;25(Suppl 2):S130–S133. DOI: 10.5005/jp-journals-10071-23814.
  4. Verma SP, Hamide A, Wadhwa J, Sivamani K. Corticosteroid responsive prolonged thrombocytopenia in a case of dengue fever. BMJ Case Rep 2013;2013:200249. DOI: 10.1136/bcr-2013-200249.
  5. Sibai BM. Diagnosis, controversies, and management of the syndrome of hemolysis, elevated liver enzymes, and low platelet count. Obstet Gynecol 2004;103:981–991. DOI: 10.1097/01.AOG.0000126245.35811.2a.
  6. ACOG Practice Bulletin No. 202: gestational hypertension and preeclampsia. Obstet Gynecol 2019;133(1):e1–e25. DOI: 10.1097/AOG.0000000000003018.
  7. Ditisheim A, Sibai BM. Diagnosis and management of HELLP syndrome complicated by liver hematoma. Clin Obstet Gynecol 2017;60(1):190–197. DOI: 10.1097/GRF.0000000000000253.
  8. Manappallil RG, Surendran S, Kumar A, Prasad G. Normotensive HELLP syndrome in the midst of Dengue fever. Asian J Med Sci 2018;9(2):40–42. DOI: 10.3126/ajms.v9i2.18764.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.