{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:02:47Z","timestamp":1790694167506,"version":"4.1.0"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T00:00:00Z","timestamp":1634169600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>Dengue fever and chikungunya are viral diseases that have spread rapidly throughout the world in recent decades. The occurrence of complications is well known, including prerenal acute kidney injury (AKI), which is usually thought to be caused by dehydration and fluid loss. Thrombotic microangiopathy (TMA) is an uncommon aggravation of dengue fever and chikungunya, with only a few cases described in the medical literature. The aim of this study is to present 3 cases of TMA associated with arboviral infection. Three patients with clinical history, laboratory test, and kidney biopsy results compatible with TMA were selected for the study, 2 of whom had a serological diagnosis of dengue fever and 1 of chikungunya. The 3 patients were followed up at the Federal University of Maranh\u00e3o Hospital\u2019s Nephrology Service in 2018. A targeted gene panel sequencing (TGPS) plus multiple to atypical hemolytic uremic syndrome (aHUS) multiplex ligation\u2013dependent probe amplification (MLPA) was performed in 2 of the patients and revealed in the patient 1 a heterozygous pathogenic variant in the gene<jats:italic>THBD<\/jats:italic>, as well as heterozygous deletions in<jats:italic>CFH<\/jats:italic>,<jats:italic>CFHR1<\/jats:italic>, and<jats:italic>CFHR3<\/jats:italic>. In the patient 2, there were heterozygous pathogenic variant in the genes<jats:italic>CFI<\/jats:italic>and<jats:italic>CFB<\/jats:italic>, in addition to heterozygous deletions in the genes<jats:italic>CFHR1<\/jats:italic>and<jats:italic>CFHR3<\/jats:italic>. Both received treatment with eculizumab and undergone recovery of renal function. The third patient had TMA not classified as either aHUS or thrombotic thrombocytopenic purpura (TTP); he abandoned the treatment and returned to the service after 2 years for a dialysis emergency. Patients with arboviral infectious disease and changes that suggest TMA should have appropriate support to establish early diagnosis and useful treatment.<\/jats:p>","DOI":"10.1371\/journal.pntd.0009790","type":"journal-article","created":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T17:45:42Z","timestamp":1634233542000},"page":"e0009790","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":19,"title":["Thrombotic microangiopathy associated with arboviral infection: Report of 3 cases"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3539-8234","authenticated-orcid":true,"given":"Jos\u00e9 Luiz","family":"Coelho J\u00fanior","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5891-4097","authenticated-orcid":true,"given":"Karla Cristina 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