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Case Reports
. 2022 Nov 23:15:6755-6761.
doi: 10.2147/IDR.S386273. eCollection 2022.

Hemorrhagic Fever with Renal Syndrome Complicated with Acute Pancreatitis and Capillary Cholangitis: A Case Report

Tingting Liu #  1 , Wu Yang #  1 , Kun Li  1 , Siruo Guo  1 , Manman Tian  1 , Xueling Fang  1
Affiliations
Case Reports

Hemorrhagic Fever with Renal Syndrome Complicated with Acute Pancreatitis and Capillary Cholangitis: A Case Report

Tingting Liu et al. Infect Drug Resist. .

Abstract

Hemorrhagic fever with renal syndrome (HFRS), caused by hanta viruses (HTNV), can be complicated by severe complications. Seventeen percent of the HFRS patients with abdominal pain had acute pancreatitis (AP). The reported prevalence of AP among HFRS patients has a conspicuous high mortality rate. Of note, acute capillary cholangitis (ACC) among HFRS patients presenting with abdominal pain appears extremely rare, particularly independent of HFRS patients complicated with AP. The main pathophysiological mechanism of HFRS complicated with AP and ACC may be that it preferentially damages the microvascular and induces plasma leakage. To date, the management of severe HFRS cases is mainly based on supportive treatment, including extracorporeal blood purification and mechanical ventilation. Here, we describe an exceptionally rare case of a 34-year man who developed HFRS with AP and ACC while improving from HTNV infection via antiviral and supportive treatment.

Keywords: abdominal pain; acute acalculous cholangitis; acute pancreatitis; hantaviruses; hemorrhagic fever with renal syndrome.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Abdominal CT images of the patient. (A) Abdominal CT on June 25, 2022. The pancreas was swollen with effusion around the pancreas and both kidneys. (B) An MRCP image of the patient on July 1, 2022. The pancreas is enlarged, surrounding tissues were exudation, and the gallbladder is full, cholestasis. (C) Abdominal CT on July 5, 2022. Compared with the abdominal CT images on June 25, 2022, the exudation around pancreas and bilateral kidneys was obviously improved.
Figure 2
Figure 2
(A–D) Trend charts for key liver, pancreas, and kidney function indicators since the day (June 25, 2022) transferred to the intensive care unit (ICU).
See this image and copyright information in PMC

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Grants and funding

This research received external funding from the Medical Science and Technology Project of Zhejiang Province (2019RC170) and the Department of Education of Zhejiang Province (Y201941857).

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