Dengue shock syndrome in renal transplant recipient. Transplant recipient

Christian Medical College & Hospital, Ludhiana, Punjab, India
Transplantation (Impact Factor: 3.83). 03/2004; 77(4):634-5. DOI: 10.1097/01.TP.0000114608.44000.D7
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    • "Different renal injuries have been described in dengue patients, such as an increase in serum creatinine, proteinuria, glomerulonephritis, hemolytic-uremic syndrome and acute kidney injury (AKI)4,10,16,37,39. Most cases of AKI have been associated with DHF or DSS6,7,20–23,25,27,34,40, but AKI has also been described in DF13–15,30,31, albeit less commonly. Similarly, rhabdomyolysis with1,5,7,19 and without AKI9,24,28 has been described in dengue patients. "
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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 04/2014; 56(1):85-88. DOI:10.1590/S0036-46652014000100014 · 1.01 Impact Factor
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    ABSTRACT: Dengue fever and its complications are a poorly described entity in the renal transplant population. Previous reports in renal transplant patients suggest a high mortality rate. We undertook a retrospective study of six cases of dengue fever in renal transplant patients during a dengue outbreak in Singapore in 2005 which involved a total of 1400 cases in the city state. Mean thrombocytopenia was 130,000/microL on presentation and 80,000/microL at deffervescence. No dengue haemorrhagic fever, dengue shock syndrome, deaths or abnormal graft function were observed. Mean hospital stay was 8.6 days. Four of six patients also had simultaneous CMV reactivation. In common with the majority of adults, dengue fever follows a benign course in the renal transplant population and dengue haemorrhagic fever is rare. This may be related to the relative immunosuppression reducing the risk for antibody-enhanced complications.
    Nephrology 07/2007; 12(3):305-7. DOI:10.1111/j.1440-1797.2007.00785.x · 2.08 Impact Factor
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    ABSTRACT: We reviewed the impact of dengue in 27 renal transplant recipients (9 females and 18 males) at a mean of 63 (6-287) months after transplantation. Their mean age was 37+/-14 years and all were first transplantations (21 live donors, 6 deceased donors). Twenty-six were dengue fever cases and one had dengue hemorrhagic fever. Symptoms were: fever (100%), muscular pain (90%), malaise (75%), and headache (68%). Eight (29%) patients were admitted to hospital with one death. All other cases had full recovery. Mean serum creatinine before dengue was 1.4+/-0.6 mg/dL, increased to a mean peak of 1.9+/-1.2 mg/dL (P<0.001), and returned to baseline after recovery (1.6+/-0.82 mg/dL, P=NS). After a mean follow-up of 39+/-18 months, four patients lost their grafts due to chronic allograft nephropathy and four died, due to infectious causes not related to dengue. The first episode of dengue in transplanted patients resembled a flu-like syndrome, as in the general population. It did not cause long-term damage to either the patient or the graft.
    Transplantation 09/2007; 84(6):792-4. DOI:10.1097/ · 3.83 Impact Factor
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