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[汉坦病毒感染所致急性肾衰竭]

[Acute kidney failure caused by hantavirus infection].

作者信息

Mettang T, Weber J, Kuhlmann U

机构信息

Innere Abteilung, Robert-Bosch-Krankenhaus, Stuttgart.

出版信息

Dtsch Med Wochenschr. 1991 Dec 13;116(50):1903-6. doi: 10.1055/s-2008-1063837.

Abstract

A 37-year-old man suddenly fell ill with high fever (up to 39.6 degrees C), headache and lumbar pain. There was marked thrombocytopenia (minimal level of 48,000/microliters), moderate anaemia and a slow rise in serum lipase concentration to maximally 1352 U/l. Marked sinus bradycardia (to as low as 34 beats/min) occurred in the further course of the disease, as well as upper abdominal pain (endoscopically diagnosed as antral gastritis), subileus and splenomegaly. Two haemodialysis treatments were needed because of acute renal failure. An IgG antibody titre of 1:512 and an IgM titre of 1:80 against hantavirus antigen confirmed that this virus was responsible for the haemorrhagic fever with renal syndrome. This infection, transmitted by wild rodents and frequently observed in Asian countries, has a rising incidence in Central Europe. It should be included in the differential diagnosis of acute renal failure of uncertain cause.

摘要

一名37岁男子突然发病,出现高热(体温高达39.6摄氏度)、头痛和腰痛。血小板显著减少(最低水平为48,000/微升),有中度贫血,血清脂肪酶浓度缓慢上升,最高达1352 U/l。在疾病的进一步发展过程中,出现了明显的窦性心动过缓(低至34次/分钟),以及上腹部疼痛(内镜诊断为胃窦炎)、不全肠梗阻和脾肿大。由于急性肾衰竭,需要进行两次血液透析治疗。针对汉坦病毒抗原的IgG抗体滴度为1:512,IgM滴度为1:80,证实该病毒是导致肾综合征出血热的病因。这种由野生啮齿动物传播的感染在亚洲国家较为常见,在中欧的发病率也在上升。在病因不明的急性肾衰竭的鉴别诊断中应考虑到这种疾病。

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