{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T02:15:16Z","timestamp":1793412916537,"version":"4.5.0"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T00:00:00Z","timestamp":1721347200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T00:00:00Z","timestamp":1721347200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Dengue fever is a mosquito-borne viral infection with a broad spectrum of clinical manifestations. Expanded dengue syndrome includes unusual manifestations that do not fall into the categories of dengue fever, dengue hemorrhagic fever, or dengue shock syndrome. Rhabdomyolysis causing acute renal failure in dengue is one such unusual manifestation, the pathophysiology of which is incompletely understood.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We describe a 21-year-old Sri Lankan man with dengue fever who developed severe rhabdomyolysis and acute kidney injury with extremely high creatinine phosphokinase levels (&gt;\u20092 million\u00a0U\/L). Management of this patient was challenging as his creatinine phosphokinase kept rising with persistent anuria despite hydration, intermittent hemodialysis, and, later, continuous venovenous hemodiafiltration. Further therapeutic options were explored, and CytoSorb\u00ae adsorber was added as an adjunct to continuous venovenous hemodiafiltration, following which we observed a marked reduction in his creatinine phosphokinase and myoglobin levels over the next 12\u00a0hours and complete renal recovery over the next 5\u00a0weeks.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>We report a rare case of significant rhabdomyolysis secondary to dengue infection leading to acute kidney injury. Continuous venovenous hemodiafiltration performed with the hemofilter Pecopen 140 was ineffective, and the addition of CytoSorb\u00ae adsorber as an adjunct therapy to continuous venovenous hemodiafiltration may have a potential benefit in removing high-molecular-weight proteins such as myoglobin.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-024-04661-6","type":"journal-article","created":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T00:01:58Z","timestamp":1721347318000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Dengue rhabdomyolysis successfully treated with hemoperfusion using CytoSorb\u00ae in combination with continuous renal replacement therapy: a case report"],"prefix":"10.1186","volume":"18","author":[{"given":"Piyum","family":"Samarasingha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harindra","family":"Karunatilake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ananda","family":"Jayanaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hansani","family":"Jayawardhana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilshan","family":"Priyankara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,19]]},"reference":[{"key":"4661_CR1","unstructured":"World Health Organization, Special Programme for Research, Training in Tropical Diseases, World Health Organization. Department of Control of Neglected Tropical Diseases, World Health Organization. Epidemic, Pandemic Alert. Dengue: guidelines for diagnosis, treatment, prevention and control. World Health Organization; 2009."},{"key":"4661_CR2","unstructured":"World Health Organization. Dengue haemorrhagic fever: diagnosis, treatment, prevention and control. World Health Organization; 1997."},{"issue":"7","key":"4661_CR3","first-page":"59","volume":"64","author":"DB Kadam","year":"2016","unstructured":"Kadam DB, Salvi S, Chandanwale A. Expanded dengue. J Assoc Physicians India. 2016;64(7):59\u201363.","journal-title":"J Assoc Physicians India"},{"issue":"1","key":"4661_CR4","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1056\/NEJMra0801327","volume":"361","author":"X Bosch","year":"2009","unstructured":"Bosch X, Poch E, Grau JM. Rhabdomyolysis and acute kidney injury. N Engl J Med. 2009;361(1):62\u201372.","journal-title":"N Engl J Med"},{"issue":"3","key":"4661_CR5","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1186\/cc13897","volume":"18","author":"N Petejova","year":"2014","unstructured":"Petejova N, Martinek A. Acute kidney injury due to rhabdomyolysis and renal replacement therapy: a critical review. Crit Care. 2014;18(3):224.","journal-title":"Crit Care"},{"issue":"2","key":"4661_CR6","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1186\/cc2978","volume":"9","author":"AL Huerta-Alard\u00edn","year":"2005","unstructured":"Huerta-Alard\u00edn AL, Varon J, Marik PE. Bench-to-bedside review: rhabdomyolysis\u2014an overview for clinicians. Crit Care. 2005;9(2):158\u201369.","journal-title":"Crit Care"},{"key":"4661_CR7","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.7126","author":"A Soliman","year":"2020","unstructured":"Soliman A, Bisht S, Jeyamurugan K, Balasundaram P, Basak R. Severe rhabdomyolysis in a pediatric patient after coxsackie b virus infection without acute renal failure: a case report. Cureus. 2020. https:\/\/doi.org\/10.7759\/cureus.7126.","journal-title":"Cureus."},{"issue":"3","key":"4661_CR8","doi-asserted-by":"publisher","first-page":"221","DOI":"10.4103\/0972-2327.70882","volume":"13","author":"S Acharya","year":"2010","unstructured":"Acharya S, Shukla S, Mahajan SN, Diwan SK. Acute dengue myositis with rhabdomyolysis and acute renal failure. Ann Indian Acad Neurol. 2010;13(3):221\u20132.","journal-title":"Ann Indian Acad Neurol"},{"key":"4661_CR9","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1002\/jmv.2190","volume":"67","author":"SJ Gagnon","year":"2002","unstructured":"Gagnon SJ, Mori M, Kurane I, Green S, Vaughn DW, Kalayanarooj S, et\u00a0al. Cytokine gene expression and protein production in peripheral blood mononuclear cells of children with acute dengue virus infections. J Med Virol. 2002;67:41\u20136.","journal-title":"J Med Virol"},{"issue":"6","key":"4661_CR10","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1111\/sdi.12963","volume":"34","author":"C Ronco","year":"2021","unstructured":"Ronco C, Reis T. Continuous renal replacement therapy and extended indications. Semin Dial. 2021;34(6):550\u201360.","journal-title":"Semin Dial"},{"issue":"3","key":"4661_CR11","first-page":"410","volume":"43","author":"T Reis","year":"2021","unstructured":"Reis T, Anwar S, Neves FADR, Ronco C. Disruptive technologies for hemodialysis: medium and high cutoff membranes. Is the future now? J Bras Nefrol. 2021;43(3):410\u20136.","journal-title":"J Bras Nefrol"},{"key":"4661_CR12","first-page":"2017","volume":"19","author":"M Pezzi","year":"2017","unstructured":"Pezzi M, Renda S, Giglio AM, Scozzafava AM, Tiburzi SP, Casella P, Iannelli F, Verre M. The use of coupled plasma filtration adsorption in traumatic rhabdomyolysis. Case Rep Crit Care. 2017;19:2017.","journal-title":"Case Rep Crit Care"},{"key":"4661_CR13","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1159\/000505899","volume":"49","author":"O Dilken","year":"2020","unstructured":"Dilken O, Ince C, van der Hoven B, Thijsse S, Ormskerk P, de Geus HRH. Successful reduction of creatine kinase and myoglobin levels in severe rhabdomyolysis using extracorporeal blood purification (CytoSorb\u00ae). Blood Purif. 2020;49:743\u20137.","journal-title":"Blood Purif"},{"key":"4661_CR14","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1159\/000508277","volume":"50","author":"HC Daum","year":"2021","unstructured":"Daum HC, Schmidt BMW, Napp LC. Effects of hemoadsorption with CytoSorb during severe rhabdomyolysis. Blood Purif. 2021;50:268\u20139.","journal-title":"Blood Purif"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-024-04661-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-024-04661-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-024-04661-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T00:02:19Z","timestamp":1721347339000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-024-04661-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,19]]},"references-count":14,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["4661"],"URL":"https:\/\/doi.org\/10.1186\/s13256-024-04661-6","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,19]]},"assertion":[{"value":"9 November 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 June 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 July 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"329"}}