Publication: False-positive nonstructural protein 1 antigen in a patient with philadelphia chromosome-positive acute lymphoblastic leukemia: A case report with literature review
Issued Date
2021-01-01
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ISSN
19415923
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2-s2.0-85103814758
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Mahidol University
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SCOPUS
Bibliographic Citation
American Journal of Case Reports. Vol.22, No.1 (2021)
Suggested Citation
Supat Chamnanchanunt, Pravinwan Thungthong, Asrinda Abdulkanan, Chajchawan Nakhakes False-positive nonstructural protein 1 antigen in a patient with philadelphia chromosome-positive acute lymphoblastic leukemia: A case report with literature review. American Journal of Case Reports. Vol.22, No.1 (2021). doi:10.12659/AJCR.928865 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78768
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Title
False-positive nonstructural protein 1 antigen in a patient with philadelphia chromosome-positive acute lymphoblastic leukemia: A case report with literature review
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Abstract
Objective: Mistake in diagnosis Background: A rapid investigation of dengue viral infection is needed for physicians who manage patients with suspected dengue infection. The nonstructural protein 1 (NS1) test kit is commonly used to diagnose patients with acute febrile illness in dengue-endemic countries, although this test kit can yield false-positive results. The Dengue NS1 test kit mostly relies on cross-reaction among febrile illness patients with other viral infections rather than malignancies. Case Report: A 52-year-old male patient presented with 3 days of fever, intermittent gum bleeding, weight loss, and mucocutaneous bleeding. He was transferred to a second hospital with acute febrile illness. Both dengue NS1 antigen test kits were positive from the 2 hospitals where he was previously treated. Fever and cytopenia persisted, and then the dengue RT-PCR test was performed to establish the cause of illness. A peripheral blood smear was reviewed and showed blast cells. A bone marrow examination was done to test for the compatibility of lymphoblastic leukemia. The flow cytometry test showed B cells ALL with Philadelphia-positive chromosome. Finally, the result of the dengue RT-PCR test was negative. Conclusions: Our patient presented with fever and viral-like illness, but he was finally diagnosed with Ph+ ALL. We demonstrated the first case of false-positive dengue NS1 antigen in a Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) patient. Moreover, we reviewed the literature to gather information on false-positive results using the dengue NS1 test kit. The dengue NS1 test kit is useful and produces reliable clinical findings, especially in patients with hematological malignancies.