CLINICAL CHARACTERISTICS AND RENAL OUTCOMES OF LASSA FEVER IN PATIENTS WITH SICKLE CELL DISEASE IN ENDEMIC REGION OF NIGERIA

Abstract

Lassa fever (LF) is a viral haemorrhagic disease endemic to West Africa and is associated with significant morbidity and mortality, particularly when complicated by acute kidney injury (AKI). Sickle cell disease (SCD), characterized by chronic hemolysis and endothelial dysfunction, may predispose affected individuals to more severe manifestations of LF; however, the clinical interaction between these conditions remains poorly described. We reported a case of severe Lassa fever complicated by rapidly progressive AKI in a 16-year-old female with homozygous sickle cell disease (HbSS). Clinical features, laboratory parameters including Lassa virus PCR cycle threshold values, therapeutic interventions, and outcomes were retrospectively reviewed. The patient presented with high-grade fever, respiratory symptoms, hemoglobinuria, electrolyte derangements, marked leukocytosis, and worsening renal function. Lassa virus PCR
confirmed active infection with low cycle threshold values. Despite aggressive supportive care, renal function deteriorated, necessitating multiple sessions of hemodialysis. Management included renal-adjusted intravenous ribavirin, blood transfusions, correction of metabolic abnormalities, and coordinated multidisciplinary care. Viral clearance was achieved by day 15, followed by gradual clinical recovery. This case highlights the synergistic severity of Lassa fever and sickle cell disease, particularly in precipitating hemolysis and acute kidney injury. Early diagnosis, prompt initiation of antiviral therapy, access to renal replacement therapy, and multidisciplinary management are critical to improving outcomes in this high-risk population. Further studies are needed to define disease patterns, optimize antiviral dosing, and develop tailored management guidelines for patients with sickle cell disease in Lassa

fever–endemic regions.