{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T06:07:25Z","timestamp":1783577245686,"version":"3.55.0"},"reference-count":18,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,6]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome is a rare complication consisting of pregnancy-induced hypertension, hemolysis, elevated liver enzymes, and thrombocytopenia. Dengue, caused by an arbovirus, manifests with fever, thrombocytopenia, and hemorrhagic symptoms. We report a 26-year-old primigravida at 29 weeks of gestation from northern Peru with preeclampsia. During hospitalization, she developed fever, thrombocytopenia, and was diagnosed with severe dengue by a positive nonstructural protein 1 antigen test. Her condition worsened because of preeclampsia with signs of severity. She was admitted to the intensive care unit, and she did undergo a cesarean section. On the seventh day, she developed HELLP syndrome and multiple organ failure, culminating in her death on the ninth day. In endemic areas, it is important to consider clinical scenarios where the simultaneous manifestation of hypertensive disease and dengue may occur in the pregnant population, as timely diagnosis and appropriate management of both diseases are key to improve clinical outcomes.<\/jats:p>","DOI":"10.4269\/ajtmh.24-0785","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T10:59:56Z","timestamp":1747738796000},"page":"344-346","source":"Crossref","is-referenced-by-count":1,"title":["Fatal Outcome in a Pregnant Woman with HELLP Syndrome and Dengue"],"prefix":"10.4269","volume":"113","author":[{"given":"Pierina A.","family":"Garavito-P\u00e9rez","sequence":"first","affiliation":[{"name":"Escuela de Medicina, Universidad C\u00e9sar Vallejo, Piura, Per\u00fa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe C.","family":"Olivares-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Hospital de Chulucanas, Piura, Per\u00fa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virgilio E.","family":"Failoc-Rojas","sequence":"additional","affiliation":[{"name":"Vicerrectorado de Investigaci\u00f3n, Universidad San Ignacio de Loyola, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel A.","family":"Vences","sequence":"additional","affiliation":[{"name":"Escuela de Medicina, Universidad C\u00e9sar Vallejo, Piura, Per\u00fa;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Curr Hypertens Rep","first-page":"66","article-title":"Prevention, diagnosis, and management of hypertensive disorders of pregnancy: A comparison of international guidelines","volume":"22","author":"Sinkey","year":"2020"},{"key":"b2","series-title":"BMJ","first-page":"l2381","article-title":"Pre-eclampsia: Pathophysiology and clinical implications","volume":"366","author":"Burton","year":"2019"},{"key":"b3","series-title":"Crit Care Nurs Clin North Am","first-page":"277","article-title":"HELLP syndrome","volume":"34","author":"Adorno","year":"2022"},{"key":"b4","series-title":"Travel Med Infect Dis","first-page":"101456","article-title":"Dengue in Honduras and the Americas: The epidemics are back!","volume":"31","author":"Zambrano","year":"2019"},{"key":"b5","series-title":"Eur J Obstet Gynecol Reprod Biol","first-page":"205","article-title":"Dengue in pregnancy: Review article","volume":"261","author":"Mulik","year":"2021"},{"key":"b6","article-title":"Dengue and Severe Dengue","year":"2024"},{"key":"b7","series-title":"Sci Rep","first-page":"9938","article-title":"Dengue in pregnancy and maternal mortality: A cohort analysis using routine data","volume":"8","author":"Paixao","year":"2018"},{"key":"b8","series-title":"Glob Adv Health Med","first-page":"38","article-title":"The CARE guidelines: Consensus-based clinical case reporting guideline development","volume":"2","author":"Gagnier","year":"2013"},{"key":"b9","article-title":"Boletin","year":"2023"},{"key":"b10","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"1","article-title":"Notes from the field: Dengue outbreak\u2014Peru","volume":"73","author":"Munayco","year":"2023"},{"key":"b11","article-title":"Situaci\u00f3n del Dengue en el Per\u00fa","year":"2024"},{"key":"b12","series-title":"Complicaciones Obst\u00e9tricas Relacionadas al Dengue Durante el Embarazo en un Hospital Estatal de Piura, 2023","author":"Bereche Quintana","year":"2023"},{"key":"b13","series-title":"Dengue: Guidelines for Diagnosis, Treatment, Prevention, and Control","year":"2009"},{"key":"b14","series-title":"Relaci\u00f3n Entre Dengue y las Complicaciones Materno-Fetales Durante El Brote en el E.S Catacaos, 2023","author":"Gomez Ayala","year":"2023"},{"key":"b15","series-title":"Complicaciones Materno-Fetales en Gestantes con Dengue y sin Dengue en el Hospital Santa Rosa, Piura","author":"Ediger Sandoval","year":"2020"},{"key":"b16","series-title":"Indian J Crit Care Med","first-page":"639","article-title":"Dengue and HELLP: Beware of the masquerade","volume":"26","author":"Patnaik","year":"2022"},{"key":"b17","series-title":"Cureus","first-page":"e48640","article-title":"A narrative review of maternal and perinatal outcomes of dengue in pregnancy","volume":"15","author":"Ahuja","year":"2023"},{"key":"b18","series-title":"Asian J Med Sci","first-page":"40","article-title":"Normotensive HELLP syndrome in the midst of Dengue fever","volume":"9","author":"Manappallil","year":"2018"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/113\/2\/article-p344.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/113\/2\/article-p344.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/113\/2\/article-p344.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T13:59:51Z","timestamp":1754488791000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/113\/2\/article-p344.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,6]]},"references-count":18,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.24-0785","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,6]]}}}