593. Clinical Impact of Extrarenal Manifestations in Hemorrhagic Fever with Renal Syndrome
Session: Poster Session: Travel Medicine/Tropical Medicine
Friday, October 30, 2009: 12:00 AM
Room: Poster Hall A
Background: In Asia and Europe, Hemorrhagic Fever with Renal Syndrome(HFRS) has higher prevalence. Reports on clinical entities mainly had focused on acute renal failure. The present study was aimed to evaluate extrarenal manifestations and clinical impact of those in HFRS patients.
Methods: The study was a retrospective cohort of 73 patients admitted with HFRS between 2000 and 2007. These patients were categorized into either extrarenal manifestation (EM) or non-extrarenal manifestations (NEM) groups according to associated manifestation.
Results: The mean age was 50.3, 56 (76.3%) were men. The mean length of hospital stay was 10.3 days and overall mortality was 6/73 (8.2%).
Twenty-three extrarenal manifestations were identified in 21 patients (28.8%). Extrarenal manifestations were classified as hepatobiliary, neurological, cardiovascular, hematologic manifestations and major bleeding. Hepatobiliary and major bleeding happened in 10.9% and 9.6%, respectively. While cardiovascular and central nervous system manifestations developed during hypotensive or oliguric phase, hepatobiliary and major bleeding were detected in variable phase.
Elevation of serum total bilirubin, aspartate aminotransferase(AST), lactate dehydrogenase(LDH) and prologation of activated partial thromboplastinTime(aPTT), the frequency of >2+ RBC at urine dipstick analysis of admission were significantly frequent in EM group.
Shock was common in EM group, and EM group had longer hospital stay.

Conclusion: These results suggest that various extrarenal manifestations can occur in HFRS and these can develop at various stage. Extrarenal manifestations are associated with severity of the disease. Therefore, knowledge about clinical manifestation and close monitoring of occurrence render earlier correct diagnosis in less endemic area.
Kyung-Hwa Park, MD, Chonnam National University, Gwangju, South Korea and  K. Park, None.