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Reversible splenium lesion of the corpus callosum in hemorrhagic fever with renal failure syndrome.

Baek SH, Shin DI, Lee HS, Lee SH, Kim HY, Shin KS, Lee SY, Han HS, Han HJ, Lee SS - J. Korean Med. Sci. (2010)

Bottom Line: This is the first case of virus-associated encephalitis/encephalopathy in which the pathogen was Hantaan virus.In the course of his illness, mild neurologic symptoms such as dizziness and confusion developed and magnetic resonance images revealed a reversible lesion in the splenium of the corpus callosum.This case suggests that HFRS patients with neurologic symptoms like dizziness and mental slowing should be considered to have structural brain lesions and to require brain imaging studies.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Chungbuk National University School of Medicine, Cheongju, Korea.

ABSTRACT
This is the first case of virus-associated encephalitis/encephalopathy in which the pathogen was Hantaan virus. A 53-yr-old man presented fever, renal failure and a hemorrhagic tendency and he was diagnosed with hemorrhagic fever with renal failure syndrome (HFRS). In the course of his illness, mild neurologic symptoms such as dizziness and confusion developed and magnetic resonance images revealed a reversible lesion in the splenium of the corpus callosum. This case suggests that HFRS patients with neurologic symptoms like dizziness and mental slowing should be considered to have structural brain lesions and to require brain imaging studies.

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Follow-up MRI obtained 14 days later. The images correspond to those in Fig. 1 and show complete resolution of the SCC lesion with no residual changes.
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Figure 4: Follow-up MRI obtained 14 days later. The images correspond to those in Fig. 1 and show complete resolution of the SCC lesion with no residual changes.

Mentions: His blood tests showed marked thrombocytopenia (21×103/µL) and azotemia (BUN/Cr 23 mg/dL/1.5 mg/dL). He was started on cefotaxime and clindamycin for a suspected infection and transfused with fresh frozen plasma, but his fever (>38.0℃) was sustained. Two days after admission, he was alert and his fever had subsided, but the oliguria, azotemia (BUN/Cr 49 mg/dL/3.0 mg/dL), and thrombocytopenia (6×103/µL) had worsened (Figs. 2, 3). Four days later, the thrombocytopenia had recovered, although the azotemia (BUN/Cr 82 mg/dL/7.1 mg/dL) had not improved. He was diagnosed with HFRS based on the detection of Hantaan virus antibody in his serum. His condition improved quickly after hemodialysis. Six days later, he was alert, and his electroencephalograph (EEG) was normal. His platelet count had stabilized (311×103/µL), and a lumbar puncture was performed. The cerebrospinal fluid (CSF) analysis revealed no cells, a nor mal protein level of 26.0 mg/L, a normal glucose level of 80 mg/dL, and no organisms on Gram staining. The MRI findings had resolved completely in follow-up studies conducted on day 14 (Fig. 4).


Reversible splenium lesion of the corpus callosum in hemorrhagic fever with renal failure syndrome.

Baek SH, Shin DI, Lee HS, Lee SH, Kim HY, Shin KS, Lee SY, Han HS, Han HJ, Lee SS - J. Korean Med. Sci. (2010)

Follow-up MRI obtained 14 days later. The images correspond to those in Fig. 1 and show complete resolution of the SCC lesion with no residual changes.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2908801&req=5

Figure 4: Follow-up MRI obtained 14 days later. The images correspond to those in Fig. 1 and show complete resolution of the SCC lesion with no residual changes.
Mentions: His blood tests showed marked thrombocytopenia (21×103/µL) and azotemia (BUN/Cr 23 mg/dL/1.5 mg/dL). He was started on cefotaxime and clindamycin for a suspected infection and transfused with fresh frozen plasma, but his fever (>38.0℃) was sustained. Two days after admission, he was alert and his fever had subsided, but the oliguria, azotemia (BUN/Cr 49 mg/dL/3.0 mg/dL), and thrombocytopenia (6×103/µL) had worsened (Figs. 2, 3). Four days later, the thrombocytopenia had recovered, although the azotemia (BUN/Cr 82 mg/dL/7.1 mg/dL) had not improved. He was diagnosed with HFRS based on the detection of Hantaan virus antibody in his serum. His condition improved quickly after hemodialysis. Six days later, he was alert, and his electroencephalograph (EEG) was normal. His platelet count had stabilized (311×103/µL), and a lumbar puncture was performed. The cerebrospinal fluid (CSF) analysis revealed no cells, a nor mal protein level of 26.0 mg/L, a normal glucose level of 80 mg/dL, and no organisms on Gram staining. The MRI findings had resolved completely in follow-up studies conducted on day 14 (Fig. 4).

Bottom Line: This is the first case of virus-associated encephalitis/encephalopathy in which the pathogen was Hantaan virus.In the course of his illness, mild neurologic symptoms such as dizziness and confusion developed and magnetic resonance images revealed a reversible lesion in the splenium of the corpus callosum.This case suggests that HFRS patients with neurologic symptoms like dizziness and mental slowing should be considered to have structural brain lesions and to require brain imaging studies.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Chungbuk National University School of Medicine, Cheongju, Korea.

ABSTRACT
This is the first case of virus-associated encephalitis/encephalopathy in which the pathogen was Hantaan virus. A 53-yr-old man presented fever, renal failure and a hemorrhagic tendency and he was diagnosed with hemorrhagic fever with renal failure syndrome (HFRS). In the course of his illness, mild neurologic symptoms such as dizziness and confusion developed and magnetic resonance images revealed a reversible lesion in the splenium of the corpus callosum. This case suggests that HFRS patients with neurologic symptoms like dizziness and mental slowing should be considered to have structural brain lesions and to require brain imaging studies.

Show MeSH
Related in: MedlinePlus