Korean J Nephrol.
1999 Jul;18(4):639-643.
A Case of Prolonged Oliguric Phase over One Month in a Patient with Hemorrhagic Fever with Renal Syndrome
- Affiliations
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- 1Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Abstract
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Hemorrhagic fever with renal syndrome(HFRS) is characterized clinically by five distinct
phases; febrile, hypotensive, oliguric, diuretic and convalescent phases. The oliguric phase
usually lasts for three to six days. We here report a case of prolonged oliguric phase over
one month in a patient with HFRS. A 36-year-old man developed oliguric acute renal failure
due to HFRS. He commenced hemodialysis on the 2nd days of hospitalization. The oliguric
phase was prolonged over one month. The endocrinologic study showed nomal range of plasma ACTH,
cortisol, thyroid hormone and slight elevation of plasma atrial natriuretic peptide at
oliguric phase. Kidney biopsy showed mononuclear cell infiltrate and associated edema in the
interstitium. Diuresis appeared at the 43th days of hospitalization, but it was inadequate.
To enhance diuresis and recovery of renal function, he was treated with steroid. Five days
after steroid treatment, massive diuresis appeared and serum creatinine decreased to 1.2mg/dL
at the 5 months after onset of the disease.