# Severe Dengue With Hyperinflammatory State and Associated Acute Pancreatitis

## TL;DR

A teenage girl with severe dengue developed mild acute pancreatitis, highlighting a rare but serious complication of the disease.

## Contribution

This case report highlights the rare association of acute pancreatitis with severe dengue and a hyperinflammatory state.

## Key findings

- The patient had severe dengue confirmed by positive NS1, IgG, and IgM tests.
- Acute pancreatitis was diagnosed via elevated lipase/amylase and imaging.
- The patient improved with hydration and fasting despite no prior pancreatitis risk factors.

## Abstract

The increase in the incidence of dengue cases in the region has led to the identification of multiple complications associated with the disease. The present study presents the case of an adolescent girl with severe dengue in a hyperinflammatory state, who presented mild acute pancreatitis. This complication, although infrequent, can be harmful. In the clinical case presented, the patient presented severe dengue, according to the clinical diagnosis. In addition, polyserositis was observed, with positive NS1, IgG, and IgM, elevated transaminases above 1000 U/L and elevated levels of inflammatory markers such as ferritin, LDH, procalcitonin, and decreased fibrinogen. The diagnosis of acute pancreatitis was established based on two main criteria: elevated serum lipase/amylase and imaging studies. The patient did not experience significant abdominal pain; however, she manifested intense and persistent nausea for a period of 3 days. Despite presenting no other risk factors for acute pancreatitis, the patient was suffering from an infectious process. Treatment consisted of a complete 24-h fast and adequate hydration, which resulted in a progressive improvement in the patient's condition.