Abstract:
Dengue is the most prevalent arthropod-transmitted infection worldwide. Its clinical presentation ranges from subclinical illness to multi-organ failure. Acute kidney injury (AKI) is one of its complications, having a number of different pathogeneses. The patient herein described presented with thrombotic microangiopathy (TMA) and rhabdomyolysis, a combination never previously reported in the literature. He was diagnosed with dengue at a primary care hospital, after which he was referred to us with fever and oliguria. His blood workup and kidney biopsy revealed a picture of combined TMA and rhabdomyolysis-induced AKI. He developed sepsis after his first session of plasmapheresis, that had to be discontinued and he was further managed with dialysis and supportive care. The patient showed remarkable recovery, regaining kidney function after one month.
摘要:
登革热是世界上最普遍的节肢动物传播的感染。其临床表现从亚临床疾病到多器官功能衰竭。急性肾损伤(AKI)是其并发症之一,有许多不同的病因。本文描述的患者出现血栓性微血管病(TMA)和横纹肌溶解症,以前文献中从未报道过的组合。他在一家初级保健医院被诊断出患有登革热,之后,他因发烧和少尿被转介给我们。他的血液检查和肾脏活检显示了TMA和横纹肌溶解症联合诱导的AKI。他在第一次血浆置换后患上了败血症,必须停药,并接受透析和支持治疗。病人恢复显著,一个月后恢复肾功能。