Malhotra Hardeep Singh, Garg Ravindra Kumar
Department of Neurology, King George's Medical University, U.P., Lucknow 226003, India.
J Neurol Sci. 2014 May 15;340(1-2):19-25. doi: 10.1016/j.jns.2014.03.016. Epub 2014 Mar 15.
Dengue-associated hypokalemic paralysis is considered an important but under-emphasized neuromuscular complication of dengue virus infection. Review of the published literature reveals that 35 instances of hypokalemic paralysis associated with dengue have been recorded from the Indian subcontinent and all but two, were males. The median age of presentation is 29 years and moderate to severe grade pure motor quadriparesis is precipitated during the phase of defervescence of moderate to high-grade fever. Recovery starts within 12h of potassium supplementation and is usually complete in a couple of days. Redistribution or increased loss of potassium from the body is speculated as the pathophysiological mechanism involved in the causation of hypokalemia. It is not possible to derive the exact etiopathological correlation from the published literature either due to a lack of comprehensive reporting or inadequate work-up of the patients. Curious is the fact that only 35 patients had manifest-paralysis when more than two-thirds affected with the dengue virus exhibit hypokalemia; whether this indicates a genetically mediated channel disorder or an incidental association remains to be seen.
登革热相关的低钾性麻痹被认为是登革热病毒感染一种重要但未得到充分重视的神经肌肉并发症。对已发表文献的回顾显示，印度次大陆已记录到35例与登革热相关的低钾性麻痹病例，除两例外，均为男性。发病的中位年龄为29岁，在中度至高热退热阶段会突然出现中度至重度的纯运动性四肢瘫。补钾后12小时内开始恢复，通常在几天内完全恢复。钾在体内的重新分布或流失增加被推测为低钾血症病因中的病理生理机制。由于缺乏全面的报告或对患者检查不充分，无法从已发表的文献中得出确切的病因病理相关性。奇怪的是，在感染登革热病毒的患者中，超过三分之二会出现低钾血症，但只有35例患者出现明显麻痹；这是表明存在基因介导的通道疾病还是偶然关联，仍有待观察。
