Beyond the norm: a rare presentation of dengue fever resulting in combined rhabdomyolysis and TMA-induced AKI-a case report.

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 combinationnever 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 tobe discontinued and he was furthermanaged with dialysis and supportive care. The patient showed remarkable recovery, regaining kidneyfunction after one month.