BACKGROUND: Leptospirosis is a re-emerging infectious disease, which may lead to multiple organ failure (MOF)and death. CASE PRESENTATION: We report the first case of severe leptospirosis complicated with acute renal and liver failure, successfully treated with albumin dialysis--molecular adsorbent recirculating system (MARS). Despite antibiotic therapy, optimum medical supportive treatment and timely initiated haemodialysis, the outcome was complicated by severe liver failure: hepatic encephalopathy grade III, hypoglycemia, prominent hyperbilirubinemia (TBIL 31.3 mg/dl, DBIL 28.6 mg/dl)and hepatic cytolysis (ALT 535 IU/l, AST 179 IU/l) and prolongation of the prothrombine time (68.4 sec). The patient underwent two sesions of albumin dialysis with the MARS procedure with complete recovery of hepatic and renal function. CONCLUSION: Albumin dialysis may confer a significant survival benefit on patients with leptospirosis-induced acute liver failure (ALF).
BACKGROUND: Leptospirosis is a re-emerging infectious disease, which may lead to multiple organ failure (MOF)and death. CASE PRESENTATION: We report the first case of severe leptospirosis complicated with acute renal and liver failure, successfully treated with albumin dialysis--molecular adsorbent recirculating system (MARS). Despite antibiotic therapy, optimum medical supportive treatment and timely initiated haemodialysis, the outcome was complicated by severe liver failure: hepatic encephalopathy grade III, hypoglycemia, prominent hyperbilirubinemia (TBIL 31.3 mg/dl, DBIL 28.6 mg/dl)and hepatic cytolysis (ALT 535 IU/l, AST 179 IU/l) and prolongation of the prothrombine time (68.4 sec). The patient underwent two sesions of albumin dialysis with the MARS procedure with complete recovery of hepatic and renal function. CONCLUSION: Albumin dialysis may confer a significant survival benefit on patients with leptospirosis-induced acute liver failure (ALF).
Authors: J Stange; S R Mitzner; T Risler; C M Erley; W Lauchart; H Goehl; S Klammt; P Peszynski; J Freytag; H Hickstein; M Löhr; S Liebe; W Schareck; U T Hopt; R Schmidt Journal: Artif Organs Date: 1999-04 Impact factor: 3.094
Authors: Adrian Covic; David J A Goldsmith; Paul Gusbeth-Tatomir; Anca Seica; Maria Covic Journal: Nephrol Dial Transplant Date: 2003-06 Impact factor: 5.992
Authors: Adrian Covic; David J A Goldsmith; Paul Gusbeth-Tatomir; Carmen Volovat; Alexandru G Dimitriu; Florin Cristogel; Aurel Bizo Journal: Liver Int Date: 2003 Impact factor: 5.828