Continuous renal replacement therapy rescues severe haemorrhagic fever with renal syndrome in pregnancy: a case report
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CASE REPORT
Open Access
Continuous renal replacement therapy rescues severe haemorrhagic fever with renal syndrome in pregnancy: a case report Xiang Ying1, Xiaoli Lai1, Xiaoxiao Jin1, Linghong Cai1 and Xiaotian Li2*
Abstract Background: Haemorrhagic fever with renal syndrome (HFRS) is a natural epidemic disease caused by various types of viruses of the genus Hantavirus, which are mainly transmitted by contact with the infected rodents and their droppings. Pregnancy complicated with HFRS is rare; however, adverse maternal and foetal outcomes may be noted. In this report, we describe a case involving a pregnant woman with HFRS who was in a state of multiple organ dysfunction syndrome (MODS) and was successfully treated with continuous renal replacement therapy (CRRT). Case presentation: A 32-year-old pregnant woman at 29 weeks of gestation was hospitalised for a fever and upper respiratory tract infection due to HFRS in winter. Persistent fever, coagulation disorder, thrombocytopenia, electrolyte imbalance, abnormal liver function, and renal failure were noted during the progression of the disease. The patient was treated with CRRT. She recovered after 21 days, and delivered a live infant by caesarean section at 38 weeks of gestation. Furthermore, obvious abnormalities were not detected during the follow-up of the mother and infant at 42 days, 3 months, 6 months, and 1 year after the delivery. Conclusions: Early diagnosis, timely application of CRRT, and comprehensive treatment may be essential for the successful treatment of patients with HFRS during pregnancy. Keywords: Haemorrhagic fever with renal syndrome, Pregnancy, Continuous renal replacement therapy, Case report
Background Haemorrhagic fever with renal syndrome (HFRS) is a natural epidemic disease caused by various species of Hantavirus, with rodents as the main source of infection. According to statistical data, the fatality rate associated with HFRS was 2.89% in China from 1950 to 2014 [1]. HFRS develops very rarely during pregnancy in China as well as in other countries. The clinical manifestation of HFRS during pregnancy is atypical, and the mortality * Correspondence: [email protected] 2 Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, Shanghai Municipality, People’s Republic of China Full list of author information is available at the end of the article
rate is high. Herein, we report the successful treatment of a case of severe HFRS complicating pregnancy.
Case presentation A 32-year-old female (gravida 5, para 1) was referred to our hospital on January 23, 2019, at 29 weeks of gestation, because of 10 days’ cough and 3 days’ fever. The patient had undergone a caesarean section in 2007. The patient was healthy prior to this episode, and she had no significant family history. During the current pregnancy, an oral glucose tolerance test (OGTT) performed at 24 weeks of gestation indicated abnormal glucose tolerance. Insulin aspart was administered to reduce the blood sugar levels, and her blood
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