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Severe Yellow Fever and Extreme Hyperferritinemia Managed with Therapeutic Plasma Exchange

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  • 1 Intensive Care Unit, Infectious Diseases Institute Emílio Ribas, São Paulo, Brazil
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A 43-year-old man was admitted to the intensive care unit and diagnosed with yellow fever. He presented with refractory bleeding, extreme hyperferritinemia, and multiple organ dysfunction syndrome, requiring renal replacement therapy, mechanical ventilation, and treatment with vasoactive drugs. Because the bleeding did not respond to fresh-frozen plasma administration, the patient received therapeutic plasma exchange, which was accompanied by a marked improvement of the clinical and biochemical parameters, including a significant decline in serum ferritin levels.

Author Notes

Address correspondence to Jaques Sztajnbok, Intensive Care Unit, Infectious Diseases Institute Emílio Ribas, Rua Cristiano Viana 765, ap:32; CEP 05411-001, São Paulo, Brazil. E-mail: jaques.sztajnbok@gmail.com

Authors’ addresses: Jaques Sztajnbok, Ceila Maria Sant’Ana Malaque, Camila Hitomi Nihei, Irene Faria Duayer, Zita Maria Leme Britto, Eduarda Gambini Beraldo, and Ralcyon Francis AzevedoTeixeira, Emílio Ribas Institute of Infectious Diseases, São Paulo, Brazil, E-mails: jaques.sztajnbok@gmail.com, ceila.malaque@emilioribas.sp.gov.br, camila.nihei@emilioribas.sp.gov.br, irene.duayer@emilioribas.sp.gov.br, zita.britto@emilioribas.sp.gov.br, eduardagambiniberaldo@gmail.com, and ralcyon.teixeira@emilioribas.sp.gov.br.

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