Nephrol Dial Transplant (2000) 15: 1588-1592
© 2000 European Renal Association-European Dialysis and Transplant Association
Intestinal protein loss in patients with haemorrhagic fever with renal syndrome
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
Background. In haemorrhagic fever with renal syndrome (HFRS) vascular dysfunction has been observed in various organs, but the involvement of the intestine has not yet been reported. This study was performed to evaluate the association of intestinal protein loss in this disease with other clinical parameters reflecting vascular permeability or disease severity.
Methods. Twenty patients with HFRS were included in this study. Intestinal protein loss was measured by 99mTc-human serum albumin (99mTc-HSA) scintigraphy in the acute stage, and quantitative analysis of protein loss was measured by the faecal clearance of alpha 1-antitrypsin (CAT) in the acute and the recovery stages. CAT was then compared with clinical parameters reflecting disease activity and vascular permeability.
Results. 99mTc-HSA scintigraphy was positive in 13 (65%) patients, and CAT in the acute stage was significantly increased as compared with CAT in the recovery stage (40.5±24.1 vs 9.2±4.2 ml/day, P<0.001). CAT was associated with serum albumin levels, frequency of hypotensive episodes, severity of acute renal failure, and degree of thrombocytopenia.
Conclusions. Our data suggest that the increased vascular permeability of HFRS is associated with the increased intestinal loss of plasma proteins, which might represent one of the parameters of disease severity in HFRS.
Keywords: haemorrhagic fever; renal syndrome; hypoalbuminaemia; intestinal tract
Correspondence and offprint requests to: Dr Byung Kee Bang, Department of Internal Medicine, Kangnam St Mary's Hospital, Catholic University Medical College, 505 Banpo Dong, Seocho Ku, Seoul 137–701, Korea.
* Preliminary results were presented at the 36th European Renal Association-European Dialysis and Transplant Association congress (Madrid, Spain) in 1999.