<abstract xmlns="http://www.w3.org/1999/xhtml"><p>Dengue virus infection most commonly has mild-to-moderate nonspecific clinical presentations that overlap with other diseases. Dengue-specific tests are commonly used for those patients with acute febrile illness in dengue-endemic areas. There is one study in vitro that showed a false-positive dengue-immunoglobulin M (dengue IgM) test for blood from a patient with systemic lupus erythematosus (SLE). Here, we demonstrated a false-positive dengue IgM test in a patient with SLE. The patient had fever, cytopenia, and a skin rash, but her clinical variables more closely matched with the criteria for SLE than the dengue infection. Vasculitis-like-lesions supported prednisolone administration and her clinical symptoms improved. This case highlights that some patients with SLE can be misdiagnosed as having a viral infection. These two diseases have similar clinical findings, such as acute febrile illness, but they are different in terms of their treatments and disease prognosis.</p></abstract>

Dengue virus infection most commonly has mild-to-moderate nonspecific clinical presentations that overlap with other diseases. Dengue-specific tests are commonly used for those patients with acute febrile illness in dengue-endemic areas. There is one study in vitro that showed a false-positive dengue-immunoglobulin M (dengue IgM) test for blood from a patient with systemic lupus erythematosus (SLE). Here, we demonstrated a false-positive dengue IgM test in a patient with SLE. The patient had fever, cytopenia, and a skin rash, but her clinical variables more closely matched with the criteria for SLE than the dengue infection. Vasculitis-like-lesions supported prednisolone administration and her clinical symptoms improved. This case highlights that some patients with SLE can be misdiagnosed as having a viral infection. These two diseases have similar clinical findings, such as acute febrile illness, but they are different in terms of their treatments and disease prognosis.

False-positive dengue IgM test result in a patient with systemic lupus erythematosus: a case report

Department of Clinical Tropical Medicine, Faculty of Tropical Medicine

Division of Hematology, Department of Medicine

Hospital for Tropical Diseases, Faculty of Tropical Medicine

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Dengue virus infection most commonly has mild-to-moderate nonspecific clinical presentations that overlap with other diseases. Dengue-specific tests are...

Day of fever	2	4	5	7	2nd wk	5th wk	6th wk	8th wk
Body temperature (°C)	39.8	39.4	37.2	36.8	36.5	36.2	36.5	36.5
Hematocrit (%)	29.4	21.9	22.0	27.5	37.3	43.7	41.3	44.3
WBC (×10³/μL)	4.1	3.7		5.1	11.4	11.9	8.4	3.6
Neutrophils (%)	64.0	59.0		71.0	79.0	75.0	62.0	41.0
Lymphocytes (%)	14.0	20.0		22.0	20.0	20.0	28.0	50.0
Atypical lymphocytes (%)	6.0	2.0		4.0	0	0	0	0
Monocytes (%)	3.0	4.0		3.0	0	4.0	9.0	8.0
Eosinophils (%)	10.0	10.0		0	1.0	0	1.0	2.0
Basophils (%)	0	0		0	0	1.0	0	0
Platelet count (×10³/μL)	59	43		58	194	275	179	202
AST (U/L)	28				16
ALT (U/L)	16				24
LDH (U/L)		523		769
NS1 Ag	Negative
Dengue virus IgM and IgG antibodies	Positive

False-positive dengue IgM test result in a patient with systemic lupus erythematosus: a case report

Article Category: Clinical vignette

Published Online: Oct 31, 2020

Page range: 209 - 213

DOI: https://doi.org/10.1515/abm-2020-0030

Keywords
connective tissue diseases, dengue virus, false positive reactions, immunoglobulin M, lupus erythematosus, systemic

© 2020 Supitcha Kamolratanakul et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1

Figure 2

Laboratory findings during hospitalization and follow-up of an acutely febrile patient with suspected dengue infection†

False-positive dengue IgM test result in a patient with systemic lupus erythematosus: a case report

Article Category: Clinical vignette

Published Online: Oct 31, 2020

Page range: 209 - 213

DOI: https://doi.org/10.1515/abm-2020-0030

Keywordsconnective tissue diseases, dengue virus, false positive reactions, immunoglobulin M, lupus erythematosus, systemic

© 2020 Supitcha Kamolratanakul et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1

Figure 2

Laboratory findings during hospitalization and follow-up of an acutely febrile patient with suspected dengue infection†

Keywords
connective tissue diseases, dengue virus, false positive reactions, immunoglobulin M, lupus erythematosus, systemic