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Acute liver failure due to leptospirosis successfully treated with MARS (molecular adsorbent recircu |
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Acute liver failure due to leptospirosis successfully treated with MARS (molecular adsorbent recirculating system) dialysis.
Int Urol Nephrol. 2007 Jan 3;
Covic A, Maftei ID, Gusbeth-Tatomir P.
Dialysis Center, "Dr. C. I. Parhon" University Hospital, Iasi, Romania,
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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).
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