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한국형 출혈열 이환후 발생된 뇌하수 전엽 기능 저하증 및 중추성 뇨붕증이 발생한 1예 보고 |
박찬원 , 도준영 , 윤경우 |
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Abstract |
Korean hemorrhagic fever (KHF) is a benign diasease caused by Hantaan virus. Generally, KHF has a benign course though severe complications have been reported. There are rare reports of KHF complicated by panhypopituitarism and central diabetes insipidus in spite of autopsy findings which show coagulation necrosis of anterior pituitary gland in almost all cases. In our case, the patient suffered from polyuria, with a daily urine product of 7 L, and general weakness after 50 th day of admission. The clinical findings, together with combined pituitary function test, water deprivation test, and hypoplastic change of pituitary gland in MRI, verified panhypopituitarism and partial central diabetes insipidus. Other reasonable explanation for the develop- ment of the diagnosis could not be found. The diagnosis of KHF was verified by a high titers of antibody against Hantaan virus in patient's serum. Hormonal substitution therapy with prednisone, thyroxine, and desmopresin was started. The clinical picture became normalized, with increased blood pressure, dereased urine output, and regained strength. In conclusion, the course of KHF is usually mild, but seriously complicated case may occur. Clinical and hormonal follow up examination might therefore be indicated in patient who had a serious course of KHF. |
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