Acute hypokalaemic quadriparesis in dengue fever

An unusual case of dengue infection presenting with hypokalemic paralysis with hypomagnesemia

“…The mechanism of hypokalemia in dengue infection is not very clear. Hypokalemic paralysis has also been described in other infections like leptospirosis and chikungunya fever [1,4,6]. Another possible mechanism in our patient may be attributed to low serum magnesium level that can inhibit muscle Na + ,K + -ATPase activity leading to decreased influx into muscle cells causing a secondary kaliuresis.…”

“…Neurological manifestations although rare, may include encephalopathy, meningoencephalitis, myositis, rhabdomyolysis, myelitis, stroke, hypokalemic paralysis, Guillain Barre Syndrome, papilledema, acute disseminated encephalomyelitis, neuromyelitis optica and optic neuritis [4,5]. Only few cases have been reported from the different institutions [6], but hypokalemic paralysis with hypomagnesemia in dengue infection has not been reported earlier. Only few cases have been reported from the different institutions [6], but hypokalemic paralysis with hypomagnesemia in dengue infection has not been reported earlier.…”

Neurological Manifestations of Dengue Infection

“…Dengue-associated hypokalemic paralysis was reported by several authors, but most studies were based on isolated case reports and short series (Esack et al, 1999 ; Santos et al, 2004 ; Kalita et al, 2005 ; Jha and Ansari, 2010 ; Roy et al, 2011 ; Jain et al, 2014 ; Maurya et al, 2016 ). Maurya and colleagues assessed 12 dengue patients with hypokalemic paralysis, who had complete and rapid recovery after potassium supplementation (Maurya et al, 2016 ).…”

Hypokalemic Quadriparesis Associated with Dengue: A Case Series

“…Another putative mechanism is intracellular shift of potassium secondary to secreted insulin in response to increased catecholamine levels during infections. 9 due to anabolic state which causes intracellular shift of potassium. 10 All three of our patients had neutropenia and it is a possibility that endogenous stimulating factors and cytokines might have led to hypokalemia.…”