# Severe Hemolytic Crisis in Uncontrolled AIHA Triggered by Dengue

## TL;DR

A woman with untreated autoimmune hemolytic anemia experienced a severe hemolytic crisis triggered by dengue, requiring careful treatment to manage both conditions.

## Contribution

This case highlights the rare but critical interaction between dengue and uncontrolled autoimmune hemolytic anemia, emphasizing the need for integrated management in endemic regions.

## Key findings

- A patient with untreated AIHA developed severe hemolytic anemia during a dengue infection.
- Treatment with methylprednisolone and supportive care stabilized the patient.
- Integrated management of autoimmune diseases and viral coinfections is crucial in dengue-endemic areas.

## Abstract

We present the case of a woman with a history of autoimmune hemolytic anemia (AIHA), untreated for 1 year, who presented with fever, myalgia, arthralgia, anemia, and thrombocytopenia, along with a positive nonstructural protein antigen 1 (NS1Ag) test. During the course of dengue, the patient developed severe hemolytic anemia, posing a potentially life-threatening scenario due to the rapid decline in hemoglobin levels and the risk of multiorgan failure. Treatment with methylprednisolone was initiated alongside supportive care for dengue, and balancing corticosteroid risks in a viral infection was crucial to stabilize the patient, ultimately leading to a favorable outcome. This case highlights the importance of prompt diagnosis and integrated management of autoimmune diseases and viral coinfections in dengue-endemic areas.