Repizo Liliany P, Malheiros Denise M, Yu Luis, Barros Rui T, Burdmann Emmanuel A
Division of Nephrology, University of Sao Paulo Medical School, Sao Paulo, Brazil, Division of Nephrology, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Rev Inst Med Trop Sao Paulo. 2014 Jan-Feb;56(1):85-8. doi: 10.1590/S0036-46652014000100014.
Renal histology results are very scarce in dengue-associated rhabdomyolysis patients developing acute kidney injury (AKI). We report a case of dengue fever-induced AKI associated to rhabdomyolysis with a renal biopsy showing acute tubular necrosis (ATN) and renal deposition of myoglobin. A 28-year-old patient who presented dengue fever (DF) complicated by severe AKI and rhabdomyolysis is described. The patient required hemodialysis for three weeks. A renal biopsy revealed ATN with positive staining for myoglobin in the renal tubuli. The patient was discharged with recovered renal function. In conclusion, this case report described a biopsy proven ATN associated to DF-induced rhabdomyolysis, in which renal deposition of myoglobin was demonstrated. We suggest that serum creatine phosphokinase should be monitored in DF patients to allow for an early diagnosis of rhabdomyolysis and the institution of renal protective measures.
在发生急性肾损伤（AKI）的登革热相关性横纹肌溶解患者中，肾脏组织学结果非常罕见。我们报告一例登革热诱发的AKI与横纹肌溶解相关病例，肾活检显示急性肾小管坏死（ATN）及肌红蛋白在肾脏沉积。描述了一名28岁出现登革热（DF）并发严重AKI和横纹肌溶解的患者。该患者需要进行三周的血液透析。肾活检显示ATN，肾小管肌红蛋白染色呈阳性。患者肾功能恢复后出院。总之，本病例报告描述了一例经活检证实的与DF诱发的横纹肌溶解相关的ATN，其中证实了肌红蛋白在肾脏的沉积。我们建议对DF患者监测血清肌酸磷酸激酶，以便早期诊断横纹肌溶解并采取肾脏保护措施。
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