A case of Rosai Dorfman disease

His fluctuating platelet count during the course of illness could be due to bone marrow suppression, platelet destruction and lining of the endothelial defects by platelets [1,4]. Higher viral titres of dengue may result in an amplified cascade of cytokines and complement activation causing platelet destruction as shown earlier [3]. His liver enzymes were well above 200 U/L indicating a marked hepatic involvement though the expected rise is < 200 U/L in dengue [4,5].