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LETTER
Year : 2014  |  Volume : 60  |  Issue : 4  |  Page : 420

Quadriparesis and hypokalemia in dengue


Department of Pulmonary Critical Care and Sleep Medicine, Vardhman Mahavir Medical College (VMMC) and Safdarjang Hospital, New Delhi, India

Date of Web Publication5-Nov-2014

Correspondence Address:
Dr. A Ray
Department of Pulmonary Critical Care and Sleep Medicine, Vardhman Mahavir Medical College (VMMC) and Safdarjang Hospital, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0022-3859.143998

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How to cite this article:
Ray A, Sharma R, Khanna A. Quadriparesis and hypokalemia in dengue. J Postgrad Med 2014;60:420

How to cite this URL:
Ray A, Sharma R, Khanna A. Quadriparesis and hypokalemia in dengue. J Postgrad Med [serial online] 2014 [cited 2019 Nov 18];60:420. Available from: http://www.jpgmonline.com/text.asp?2014/60/4/420/143998


Sir,

We read with interest the article "Dengue infection presenting as acute hypokalemic quadriparesis" by Gupta et al.[1] and would like to make the following observations. As mentioned by the authors quadriparesis can occur rarely in dengue patients and the reported causes include acute disseminated encephalomyelitis, [2] acute transverse myelitis [3] and compressive myelopathy, [4] acute inflammatory demyelinating polyneuropathy, [5] acute motor sensory axonal neuropathy, [6] acute motor axonal neuropathy, [7] hypokalemic paralysis, [8],[9] neuralgic amyotrophy [10] and myostis. [11] The genesis of hypokalemia could also result from a host of causes that include redistribution of potassium into cells either due to increased catecholamine release and/or due to secondary insulin resistance, transient renal tubular abnormalities leading to increased urinary potassium wasting, increased potassium consumption due to rapid cell growth, potassium loss due to vomiting and diarrhea [11] and hyperreninemia due to hypovolemia. [12]

 
 :: References Top

1.
Gupta N, Garg A, Chhabra P. Dengue infection presenting as acute hypokalemic quadriparesis. J Postgrad Med 2014;60:327-8.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Koshy JM, Joseph DM, John M, Mani A, Malhotra N, Abraham GM, et al. Spectrum of neurological manifestations in dengue virus infection in Northwest India. Trop Doct 2012;42:191-4.  Back to cited text no. 2
    
3.
Hendarto SK, Hadinegoro SR. Dengue encephalopathy. Acta Paediatr Jpn 1992;34:350-7.  Back to cited text no. 3
    
4.
Gupta M, Nayak R, Khwaja GA, Chowdhury D. Acute disseminated encephalomyelitis associated with dengue infection: A case report with literature review. J Neurol Sci 2013;335:216-8.  Back to cited text no. 4
    
5.
Chanthamat N, Sathirapanya P. Acute transverse myelitis associated with dengue viral infection. J Spinal Cord Med 2010;33:425-7.  Back to cited text no. 5
    
6.
Verma SP, Himanshu D, Tripathi AK, Vaish AK, Jain N. An atypical case of dengue haemorrhagic fever presenting as quadriparesis due to compressive myelopathy. BMJ Case Rep 2011;2011.pii:bcr1020103421.  Back to cited text no. 6
    
7.
Gonçalves E. Acute inflammatory demyelinating polyradiculoneuropathy (Guillain-Barré syndrome) following dengue fever. Rev Inst Med Trop Sao Paulo 2011;53:223-5.  Back to cited text no. 7
    
8.
Sharma CM, Kumawat BL, Ralot T, Tripathi G, Dixit S. Guillain-Barre syndrome occurring during dengue fever. J Indian Med Assoc 2011;109:675, 682.  Back to cited text no. 8
    
9.
Mittal M, Jain N. Subdural haematoma and axonal polyneuropathy complicating dengue fever. BMJ Case Rep 2011;2011.pii:bcr1220103672.  Back to cited text no. 9
    
10.
Gupta DK, Vaish AK, Arya RK, Chaudhary SC. Hypokalaemic quadriparesis: An unusual manifestation of dengue fever. BMJ Case Rep 2011;2011.pii:bcr1220103673.  Back to cited text no. 10
    
11.
Roy A, Tripathi AK, Verma SP, Reddy H, Jain N. Acute hypokalaemic quadriparesis indengue fever. BMJ Case Rep 2011;2011.pii:bcr1120103514.  Back to cited text no. 11
    
12.
Verma R, Sharma P, Khurana N, Sharma LN. Neuralgic amyotrophy associated with dengue fever: Case series of three patients. J Postgrad Med 2011;57:329-31  Back to cited text no. 12
    




 

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