-
Views
-
Cite
Cite
Eun Young Lee, Chang Ho Song, Seung Ok Choi, Acute polyarthritis associated with hantavirus infection, Nephrology Dialysis Transplantation, Volume 14, Issue 9, September 1999, Pages 2204–2205, https://doi.org/10.1093/ndt/14.9.2204
Close - Share Icon Share
Extract
Introduction
Haemorrhagic fever with renal syndrome (HFRS) is the most common clinical manifestation of hantavirus infection. The major clinical findings are fever, headache, lumbar pain, and abdominal pain. However, a wide variety of additional symptoms can also occur since multiple organ systems are involved in HFRS, for example, the kidneys, the gastrointestinal tract, the respiratory tract, and the central nervous system [1,2]. But acute polyarthritis as a clinical manifestation of HFRS has not been previously reported.
We report the case of a 63-year-old Korean man who developed fever, chills, pharyngitis, and acute polyarthalgia with renal failure. To our knowledge, this is the first report of acute polyarthritis in HFRS.
Case
A 63-year-old Korean male had been well until 5 days before admission, when abrupt fever, chills, pharyngitis, nausea, vomiting, and polyarthralgia including hands, shoulders, and hips developed, followed by generalized oedema and decreased urine output. The multiple joint pain were persistent in a wax-and-wane pattern. There was no history of tuberculosis, diabetes mellitus, hypertension, hepatitis, arthritis, or other autoimmune disease. Three years ago the patient was diagnosed with a duodenal ulcer and then cured. He was on no regular medication. He was a farmer. The temperature was 37.8°C, blood pressure 140/90 mmHg, and pulse rate 64 beats/min. On physical examination, the patient appeared ill, with a puffy face and conjunctival injection. Coarse breathing sounds with rales on the entire lung fields and decreased breathing sounds on right lower lung fields were heard on auscultation. There was bilateral costovertebral angle tenderness. Marked pretibial pitting oedema was also noted. There were swelling and tenderness on the proximal interphalangeal joint of both 2nd fingers and the left 5th finger, and tenderness on the right shoulder and both hip joints. Morning stiffness, which persisted over 1 h, was noted. There were no rheumatoid nodules.
Comments