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| 핍뇨기가 40일 이상 지속된 신증후 출혈열 1예 (A Case of Prolonged Oliguric Phase over One Month in a Patient with Hemorrhagic Fever with Renal Syndrome) |
| 김세희, 김영옥, 김민정, 박준일, 윤선애, 양철우, 방병기 (Se Hee Kim, Young Ok Kim, Min Jeong Kim, Joon Il Park, Sun Ae Yoon, Chul Woo Yang and Byung Kee Bang) |
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| 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. |
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