Dengue Associated Demyelinating Disorders - A Report of 2 Cases.

Dengue is a common viral infection worldwide, though its neurological manifestations are infrequent (2%-11% in recent years) and can be varied as the Dengue virus per se is a non-neurotropic virus. Neurological manifestations of Dengue usually result from multisystem dysfunction which may be secondary to vascular leak or it can be due to direct virus invasion (dengue encephalitis) or an immunological phenomenon which is triggered by dengue infection (demyelinating disorders). Here we present two cases of dengue fever associated demyelinating disorders in two pediatric patients aptly depicting the two spectra of the disease. One of them is a case of fatal acute hemorrhagic leukoencephalopathy (AHLE) in a 3-year-old girl, that developed severe neurological sequelae while the other one is a case of an Acute disseminated Encephalomyelitis (ADEM) in a 3-year-old boy who had recovered with timely immunomodulatory therapy and appropriate management.

Nephrotic syndrome complicated with severe dengue infection in a child.

Dengue illness is characterised by plasma leakage with or without bleeding, which may lead to dengue shock syndrome. Proteinuria and hypoalbuminaemia are common in dengue infection, and few cases of heavy proteinuria have been reported. Dengue infection features may mimic nephrotic syndrome in clinical practice. As dengue infection is endemic in India, it can be associated with other illnesses such as nephrotic syndrome. We report a child with nephrotic syndrome complicated with severe dengue infection.

Peripheral edema in a child with a new diagnosis of insulin-dependent diabetes mellitus

Peripheral or generalized edema is an uncommon complication of insulin therapy in diabetes mellitus. The exact cause is yet not known. It is transient and self-limiting in nature. However, diuretics and aldosterone antagonists have been used in some cases. We report the case of a 14-year-old boy with newly diagnosed Type 1 diabetes who developed edema after the commencement of insulin therapy. Other causes of edema were excluded from the study. The child was managed conservatively and edema seemed to start decreasing after 72 h and completely disappear in 2 weeks.