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| Year : 2014 | Volume
: 60
| Issue : 4 | Page : 420 |
Quadriparesis and hypokalemia in dengue
A Ray, R Sharma, A Khanna
Department of Pulmonary Critical Care and Sleep Medicine, Vardhman Mahavir Medical College (VMMC) and Safdarjang Hospital, New Delhi, India
| Date of Web Publication | 5-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
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0022-3859.143998
How to cite this article:
Ray A, Sharma R, Khanna A. Quadriparesis and hypokalemia in dengue. J Postgrad Med 2014;60:420 |
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 | |  |
| 1. | Gupta N, Garg A, Chhabra P. Dengue infection presenting as acute hypokalemic quadriparesis. J Postgrad Med 2014;60:327-8.  [ PUBMED]  |
| 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. |
| 3. | Hendarto SK, Hadinegoro SR. Dengue encephalopathy. Acta Paediatr Jpn 1992;34:350-7. |
| 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. |
| 5. | Chanthamat N, Sathirapanya P. Acute transverse myelitis associated with dengue viral infection. J Spinal Cord Med 2010;33:425-7. |
| 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. |
| 7. | Gonçalves E. Acute inflammatory demyelinating polyradiculoneuropathy (Guillain-Barré syndrome) following dengue fever. Rev Inst Med Trop Sao Paulo 2011;53:223-5. |
| 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. |
| 9. | Mittal M, Jain N. Subdural haematoma and axonal polyneuropathy complicating dengue fever. BMJ Case Rep 2011;2011.pii:bcr1220103672. |
| 10. | Gupta DK, Vaish AK, Arya RK, Chaudhary SC. Hypokalaemic quadriparesis: An unusual manifestation of dengue fever. BMJ Case Rep 2011;2011.pii:bcr1220103673. |
| 11. | Roy A, Tripathi AK, Verma SP, Reddy H, Jain N. Acute hypokalaemic quadriparesis indengue fever. BMJ Case Rep 2011;2011.pii:bcr1120103514. |
| 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 |
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