Rhabdomyolysis with Myoglobinuria in Dengue Fever
Rhabdomyolysis with Myoglobinuria in Dengue Fever
Rhabdomyolysis with Myoglobinuria in Dengue Fever
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226 วิเชียร มงคลศรีตระกูล<strong>Rhabdomyolysis</strong> <strong>with</strong> <strong>Myoglob<strong>in</strong>uria</strong> <strong>in</strong> <strong>Dengue</strong> <strong>Fever</strong>:A Case Report and Review LiteratureWichean MongkonsritragoonDivision of Hematology, Department of Medic<strong>in</strong>e, Phramongkutklao HospitalAbstract:A Thai 46 year-old male, lived <strong>in</strong> Bangkok, came <strong>with</strong> acute fever for1 week. He had darkur<strong>in</strong>e for4 days. On physical exam<strong>in</strong>ation, he had jaundice <strong>with</strong> distend abdomen. The ur<strong>in</strong>e exam<strong>in</strong>ation disclosed dark and clear ur<strong>in</strong>e <strong>with</strong> specific gravity 1.018, blood-negative,RBC-negative, WBC-1-2/HPF. Myoglob<strong>in</strong> <strong>in</strong> ur<strong>in</strong>e was positive. Blood exam<strong>in</strong>ation was progressive thrombocytopenia <strong>with</strong>evidence of hemoconcentration. Liver function test showed total bilirub<strong>in</strong> 1.7 mg/dL, SGOT 1,625 u/L, SGPT 567 u/L, and alkal<strong>in</strong>e phosphatase 121 u/L. The serum BUN and creat<strong>in</strong><strong>in</strong>e are 29 mg/dL 2.1mg/dL. Abdom<strong>in</strong>al ultrasound demonstrated hepatomegaly. The patient had elevated muscle enzymes(LDH 13,144 u/L and CPK 1,529 u/L). Antibody for leptospira was negative but for <strong>Dengue</strong> virus (IgM)was positive. The patient was recovered after supportive care <strong>with</strong> out any complications. Conclusion:We describea patient who developed rhadomyolysis <strong>with</strong> myoglob<strong>in</strong>uria due to dengue virus <strong>in</strong>fectionwhich is not well described asa complication of this <strong>in</strong>fection and is probably underrecognized.Key Words : • <strong>Rhabdomyolysis</strong> • Myoglog<strong>in</strong>uria • <strong>Dengue</strong>feverThai J Hematol Transf Med 2006;16:221-6.Thai Journal of Hematology and Transfusion Medic<strong>in</strong>e Vol. 16 No. 3 July-September 2006