A rare but potentially lethal complication of dengue

Abstract

Severe rhabdomyolysis is an uncommon but potentially fatal complication of dengue fever that is not well characterised and may be underreported. With the resurgence and continued rise of dengue cases worldwide, physicians must be aware of the less common but serious complications of dengue. Here, we report a patient who presented with severe rhabdomyolysis secondary to dengue fever with a serum creatine kinase of 742 900 U/L.

Successful treatment of thrombotic microangiopathy associated with dengue infection: A case report and literature review

“…Renal disorders associated with DENV have not been extensively studied; available data are heterogeneous and the majority of information comes from case series or reports, in which the incidence varies from 0.3% to 13.3% . Renal complications include acute tubular necrosis, tubulointerstitial nephritis, TMA, nephritic, and nephrotic syndrome . The risk factors associated with acute kidney injury (AKI) in dengue are old age, male gender, severe dengue, shock, neurological involvement, prolonged activated partial thromboplastin time, and use of nephrotoxic drugs .…”

“…[11][12][13] Renal complications include acute tubular necrosis, tubulointerstitial nephritis, TMA, nephritic, and nephrotic syndrome. [12][13][14][15][16] The risk factors associated with acute kidney injury (AKI) in dengue are old age, male gender, severe dengue, shock, neurological involvement, prolonged activated partial thromboplastin time, and use of nephrotoxic drugs. 11,13,17,18 Glomerular changes have been poorly described because renal biopsy is not routinely performed because of the risk of bleeding.…”

Clinical Features of and Risk Factors for Rhabdomyolysis Among Adult Patients with Dengue Virus Infection

“…5,6 As the number of dengue cases is increasing globally, 1 the incidence of rhabdomyolysis associated with DENV infection is also increasing. [7][8][9][10][11][12][13][14][15][16][17][18] Rhabdomyolysis is a potentially life-threatening syndrome characterized by the breakdown of skeletal muscle. 19 Inappropriate treatment of this condition can lead to electrolyte disturbances, metabolic acidosis, coagulation defects, and acute kidney injury.…”

“…[19][20][21][22][23][24] However, only a few studies on rhabdomyolysis associated with DENV infection are available, and all of them are case reports or literature reviews. [7][8][9][10][11][12][13][14][15][16][17][18] The uncommon and atypical manifestation of dengue-related rhabdomyolysis has limited clinician awareness. Delayed or missed diagnosis and inappropriate treatment of dengue-related rhabdomyolysis could result in serious complications, such as acute kidney injury and even death.…”

“…Delayed or missed diagnosis and inappropriate treatment of dengue-related rhabdomyolysis could result in serious complications, such as acute kidney injury and even death. [7][8][9][10][11][12][13][14][15][16][17][18] To elucidate the clinical features of and risk factors for denguerelated rhabdomyolysis, we conducted a retrospective analysis of patients with dengue that was diagnosed over an 11-year period in a large medical center. We aimed to better understand the demographic, clinical, and laboratory characteristics of rhabdomyolysis in adult dengue patients and identify the risk factor(s) for developing rhabdomyolysis as well as cytokine/ chemokine responses in dengue patients with rhabdomyolysis.…”