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Transient splenial lesion due to non-cirrhotic hyperammonaemia in dengue fever

Robin George Manappallil1, Sunil V Nair2, Aryashree Kakkattil1

  • 1Department of Internal Medicine, Baby Memorial Hospital, Calicut, Kerala, India.

BMJ Case Reports
|June 30, 2019
PubMed

Insights

Transient splenial lesions (TSL) on MRI brain scans can occur in various conditions. This study reports a rare case of TSL linked to non-cirrhotic hyperammonaemia in a patient with dengue fever.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Transient splenial lesions (TSL) are MRI findings associated with diverse neurological conditions.
  • Dengue fever (DF) is a prevalent tropical viral illness with potential neurological complications.
  • Non-cirrhotic hyperammonaemia is a rare metabolic disturbance, and its association with DF is not previously documented.

Observation:

  • A patient with dengue fever presented with dysarthria.
  • Cerebral MRI revealed splenial hyperintensity, indicative of a transient splenial lesion.
  • Further investigations identified non-cirrhotic hyperammonaemia as the underlying cause.

Findings:

  • This case highlights an unreported association between transient splenial lesions and non-cirrhotic hyperammonaemia in the context of dengue fever.
  • The findings suggest that TSL on MRI may be a potential indicator of hyperammonaemia in DF patients.

Implications:

  • This discovery expands the differential diagnosis for TSL in endemic regions for dengue fever.
  • It underscores the importance of considering metabolic disturbances like hyperammonaemia in patients with dengue and neurological symptoms.
  • Further research is warranted to elucidate the pathophysiology and clinical significance of this association.
Keywords:
Dengue feverhyperammonemiatransient spenial lesion

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