Department of Pediatrics Nephrology, First Hospital, Jilin University, Changchun, 130021, Jilin, China.
BMC Nephrol. 2019 Oct 23;20(1):383. doi: 10.1186/s12882-019-1562-0.
Hemorrhagic fever with renal syndrome (HFRS) is an acute disease caused by hantavirus infection and is clinically characterized by fever, various hemorrhagic manifestations and transient renal and hepatic dysfunctions. Although various cases of HFRS have been reported, cases in children have rarely been described. Herein, we report two atypical cases of HFRS in children without distinctive manifestations and typical disease clinically progresses.
Patient 1 was a 11-year-old girl who attended our clinic for fever accompanying with acute renal failure, proteinuria and decreased level of complement 3 (C) and thrombocytopenia without any hemorrhagic manifestations, acute glomerulonephritis was suspected first, especially lupus nephritis. Patient 2 was misdiagnosed as encephalitis at local hospital because of fever and headache for 4 days. With elevated liver transaminases, proteinuria and normal cerebrospinal fluid examination, HFRS was taken into consideration. Both of the two cases were supported and confirmed by serological test for Hantavirus.
Clinical manifestations of HFRS in children often presented atypically and were milder than adults. Febrile disease accompanying with thrombocytopenia may lead to the suspected diagnosis of HFRS.
肾综合征出血热（HFRS）是一种由汉坦病毒感染引起的急性疾病，临床上以发热、各种出血表现以及短暂的肾和肝功能障碍为特征。尽管已经报道了各种 HFRS 病例，但很少有描述儿童病例的报道。在此，我们报告了两例儿童不典型 HFRS 病例，这些病例临床上无明显表现且病情进展典型。
患者 1 为 11 岁女孩，因发热伴急性肾衰竭、蛋白尿、补体 3（C）水平下降和血小板减少而就诊于我院，无任何出血表现，首先怀疑为急性肾小球肾炎，特别是狼疮性肾炎。患者 2 因发热、头痛 4 天在当地医院误诊为脑炎。因肝转氨酶升高、蛋白尿和正常的脑脊液检查，考虑 HFRS。这两例均通过汉坦病毒血清学试验得到支持和确诊。
儿童 HFRS 的临床表现常不典型且比成人轻。伴有血小板减少的发热性疾病可能导致 HFRS 的疑似诊断。
