Dengue shock syndrome in a renal transplant recipient.

Transplantation (Impact Factor: 3.78). 03/2004; 77(4):634-5. DOI: 10.1097/01.TP.0000114608.44000.D7
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    ABSTRACT: Renal histology results are very scarce in dengue-associated rhabdomyolysis patients developing acute kidney injury (AKI). We report a case of dengue fever-induced AKI associated to rhabdomyolysis with a renal biopsy showing acute tubular necrosis (ATN) and renal deposition of myoglobin. A 28-year-old patient who presented dengue fever (DF) complicated by severe AKI and rhabdomyolysis is described. The patient required hemodialysis for three weeks. A renal biopsy revealed ATN with positive staining for myoglobin in the renal tubuli. The patient was discharged with recovered renal function. In conclusion, this case report described a biopsy proven ATN associated to DF-induced rhabdomyolysis, in which renal deposition of myoglobin was demonstrated. We suggest that serum creatine phosphokinase should be monitored in DF patients to allow for an early diagnosis of rhabdomyolysis and the institution of renal protective measures.
    Revista do Instituto de Medicina Tropical de São Paulo 56(1):85-88. · 0.96 Impact Factor
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    ABSTRACT: Dengue is the most rapidly spreading mosquito-borne viral disease in the world. Besides bleeding, cases of hepatic and renal dysfunction in dengue fever are increasing in incidence. In management of hemorrhagic complications, fresh whole blood is far superior to platelet transfusion and fresh frozen plasma. This work is aimed at studying the incidence of hepatorenal and haematological complications and the management of symptomatic bleed with fresh whole blood in dengue fever. A prospective design was carried out with 62 Dengue positive patients either admitted in wards or attending Medicine Out Patient Department of MLB Medical College Jhansi were recruited in this study between 1 st January 2010 and 31 st December 2010. Patients were assessed for hepatorenal and haematological complications as well as management of symptomatic bleed were also studied. Incidence of jaundice in dengue fever was 15% of which one third cases were of direct hyperbilirubinemia and two third those of indirect hyperbilirubinemia. Serum glutamate pyruvate transaminase (SGPT) was raised in 68% patients while serum glutamate oxaloacetate transaminase (SGOT) was high in 71% patients. Incidence of renal failure in dengue fever was 16% (as per glomerular filtration rate (GRF) levels calculated by modified diet in renal disease formula). The leucopenia was seen in 31% and leucocytosis in 17%. Although the incidence of thrombocytopenia was observed in 92% while bleeding was seen in 32% cases only. All the cases were managed with fresh whole blood transfusion and 100% successful outcome. Incidences of hepatic and renal complications were present in 85 and 39% cases, respectively. Bleeding manifestations were seen in 32% cases, which do not correspond always to platelet counts and respond to fresh whole blood transfusion excellently.
    Journal of Infectious Diseases and Immunity. 01/2011; 3:124-133.
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    ABSTRACT: Venous drainage of the right paramedian sector (segments V and VIII), which is mainly via the middle hepatic vein (MHV), remains the major concern when using a right liver graft in living donor liver transplantation (LDLT). We herein describe our approach to decision making in the reconstruction of MHV tributaries in LDLT using a right liver graft without the MHV trunk.
    World Journal of Surgery 06/2014; · 2.23 Impact Factor