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

Correspondence Address:
Dr. A Ray
Department of Pulmonary Critical Care and Sleep Medicine, Vardhman Mahavir Medical College (VMMC) and Safdarjang Hospital, New Delhi
India

Full Text

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]

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