Topic:

Virology and viral infections (non-hiV)

Abstract No.:

ISE.295

Title:

Hemorrhagic fever with renal syndrome complicated with acute pancreatitis

Author(s):

E. Puca¹, P. Pipero¹, A. Pilaca¹, A. Harxhi¹, T. Kalo¹, S. Kurti¹, G. Stroni¹, D. Kraja¹, A. Beqiri², E. Y. Puca³; ¹University Hospital Center "Mother Teresa", Department of Infection Diseases, Tirana/AL, ²U.H.C "Mother Teresa", General Surgery Department, Tirana, ALBANIA/AL, ³American Hospital 2, Endocrinology, Tirana/AL

Abstract:

Background: Hemorrhagic fever with renal syndrome (HFRS) is a systemic infectious disease caused by Hantaviruses and characterized by fever, bleeding tendency, gastrointestinal symptoms and renal failure. During the course of HFRS, acute pancreatitis is not a common association of diseases.
Methods: A 53-year-old male diabetic was admitted to the hospital with a history of fever, myalgia and chills. Vital signs were as follows: blood pressure 90/70 mmHg; temperature 38.20C; pulse 92 bpm; and respiratory rate 28/min. His sclera was with conjunctivitis. Laboratory tests were: Hemoglobin 14,6 g/dl, WBC 12200/μL (4.0-10.0×103), red blood cells 4.73×106/mm3 (4.2-5.8×106), hematocrit 52.2% (37.0-50.0), platelet count 65×10³/μL (150-400×103), ESR 31 mm/h, creatinine 2.84 mg/dL (0.66-1.44), BUN 104 mg/dL (10.0-43.0), glucose 599 mg/dL, C-reactive protein 5 mg/liter (0-0.5). The patient complained of increasing abdominal pain throughout his hospital stay on third day. The laboratory findings showed amylase 75.2 U/L (28 - 100) and lipase 141.2 (13-60). Computed tomography of the abdominal region revealed edema of pancreas and peripancreatic tissues.
Results: The antibody for Dobrava virus infection detected by IFA and by ELISA was found to be positive for IgM class. Screening for CCHF and Leptospira were negative. Based on epidemiologic, clinic, laboratory and imagery dates', we concluded that the patient was infected by Dobrava virus and complicated with acute pancreatitis.
Conclusion: Maybe, acute pancreatitis in patients with HFRS is much more common than was previously recognized, and it is associated with increased morbidity. Therefore, we need to be suspicious of pancreatitis in HFRS. From a public health perspective, we suggest that future efforts in our country should be directed toward increasing the understanding and the awareness of HFRS among clinicians, educating the population at risk on the application of prophylactic measures and expanding the availability of diagnostic laboratory tools.