Avtor/Urednik     Martinuč, Maja; Lindič, Jelka; Kovač, Damjan; Ferluga, Dušan; Pajek, Jernej
Naslov     Successful treatment of severe hantavirus nephritis with corticosteroids
Tip     članek
Vir     In: Special issue : contributions from the 5th Slovenian Congress of Nephrology with international participation [S. l.] : International Society for Apheresis
Leto izdaje     2013
Obseg     str. 402-406
Jezik     eng
Abstrakt     Hantaviruses can be associated with severe form of hemorrhagic fever with renal syndrome although there are only a few cases reporting chronic kidney disease after hantavirus infection. We report a severe nonresolving chronic renal failure after protracted Dobrava hantavirus infection successfully treated with corticosteroids.Ten days after working in a basement a 33-year-old man fell seriously ill, with high fever, chills, diffuse myalgia, headache and abdominal pain. After hospital admission a diagnosis of hemorrhagic fever with renal syndrome caused by Dobrava hantavirus was made.Acute oliguric kidney injury developed in the first 3 days after admission, in a few days diuresis restored and he became polyuric. Nevertheless renal failure persisted and he needed hemodialysis. Because of nonresolving kidney failure, nephrogenic diabetes insipidus and renoparenchymal arterial hypertension persisting 2 months after onset of symptoms, a kidney biopsy was performed, showing severe necrotizing tubulointerstitial nephritis. High dose methylprednisolone therapy was started and his renal function significantly improved.Two months later a second renal biopsy showed persisting elements of active necrotizing tubulointerstitial nephritis.We decided to stop corticosteroid treatment and introduced aldosterone antagonist eplerenon as antifibrotic agent, and his renal function further improved and remained stable. Nine months later his serum creatinine concentration was 227 mmol/L, proteinuria 0.156 g/day and well controlled nephrogenic diabetes insipidus.
Proste vsebinske oznake     chronic kidney disease
corticosteroid
Dobrava hantavirus
eplerenone
hemorrhagic fever with renal syndrome