Use of single-pass albumin dialysis in a patient with acute liver failure due to dengue: A case report

Dengue is the most common arboviral infection worldwide, and up to 5% of patients may develop severe forms with multiorgan involvement and an increased risk of death. We present the case of a 39-year-old woman from an endemic area, living in an urban setting, who presented with five days of fever associated with myalgias and vaginal bleeding. On admission, severe thrombocytopenia and acute hepatic and renal dysfunction were documented. Despite initial treatment with crystalloids, her condition progressively worsened, leading to acute liver failure and worsening acute kidney injury, requiring invasive mechanical ventilation, vasopressor support, and single-pass albumin dialysis plus continuous veno-venous hemodiafiltration. The patient showed clinical improvement with progressive recovery of liver and kidney function and was transferred to general hospitalization after 12 days in intensive care. This case highlights the potential usefulness of this therapy in patients with acute liver failure in settings without access to advanced liver support systems or when liver transplantation is contraindicated.