Dengue, rhabdomyolysis, and lupus

How to cite this article:
Joob B, Wiwanitkit V. Dengue, rhabdomyolysis, and lupus. Ann Trop Med Public Health 2016;9:133


How to cite this URL:
Joob B, Wiwanitkit V. Dengue, rhabdomyolysis, and lupus. Ann Trop Med Public Health [serial online] 2016 [cited 2016 Aug 29];9:133. Available from:

Dear Sir,

The existence of dengue in a patient with underlying autoimmune disease is very interesting. The recent report on a case with dengue, rhabdomyolysis, and lupus by Verdolin et al. is very useful. [1] Verdolin et al. concluded that “this case demonstrates how alike dengue fever and a lupus flare are, warning clinicians that, especially during an epidemic, both diseases should be carefully differentiated in order to establish a correct and efficient therapy.” [1] Indeed, dengue is not a rare disease in tropical countries and the occurrence of dengue in patients with underlying medical illnesses is usually problematic. In case of lupus, it is also evidenced that dengue can trigger the flare-up of lupus and can also lead to severe complications such as lupus nephritis. [2],[3] In the present case, this lupus patient developed an acute febrile illness and this should be the clue for working up. To diagnose dengue, the classical clinical diagnosis such as the basic tourniquet test and complete blood count might be useful for making a presumptive diagnosis. [4],[5] Waiting for serological confirmation might be late for proper management. However, in the present case, this basic concept might be overlooked. The delayed fluid therapy might be an important underlying factor leading to the occurrence of rhabdomyolysis in the present case.

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Verdolin LD, Borner AR, Mussi H, Gismondi RA, Schau B, Ramos RC. Rhabdomyolysis associated with dengue fever in a lupic patient Rev Bras Reumatol 2014;54:318-21.
Rajadhyaksha A, Mehra S. Dengue fever evolving into systemic lupus erythematosus and lupus nephritis: A case report. Lupus 2012;21:999-1002.
Talib SH, Bhattu S, Bhattu R, Deshpande S, Dahiphale D. Dengue fever triggering systemic lupus erythematosus and lupus nephritis: A case report. Int Med Case Rep J 2013;6:71-5.
Wiwanitkit V. The tourniquet test is still a good screening tool for dengue illness. Trop Doct 2005;35:127-8.
Wiwanitkit V. Dengue fever: Diagnosis and treatment. Expert Rev Anti Infect Ther 2010;8:841-5.

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1755-6783.177399

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