Hemorrhagic Fever with Renal Syndrome Complicated with Acute Pancreatitis and Capillary Cholangitis: A Case Report

Figures & data

Table 1 Biological Parameters of the Patient

	Reference Range	June 23	June 25	June 28	July 2	July 5	July 15
WBC (109/L)	4–10	4.67	16.32	21.11	11.46	8.84	7.6
Neutrophil	2–7	3.56	13.1	10.56	9.17	7.33	5.65
HB (g/l)	131–172	156	188	105	70	84	86
PLT (109/L)	83–303	131	28	40	171	223	285
CRP (mg/L)	0–8	31.79	55.42	31	39.74	11.25	1.07
PCT (ng/mL)	0–5	2.05	24.58	4.51	2.11	1.39
T. BIL (umol/L)	0–26	28.38	68.1	159.2	462.1	344.2	84.6
D. BIL (umol/L)	0–8	10.8	50.8	134.5	363.4	253.4	72.7
TBA (umol/L)	0–10	16.7		10.2	8	11.7	4.2
AST (U/L)	15–40	132.5	364	504	307	189	184
ALT (U/L)	9–50	108	140	170	200	268	262
LDH (U/L)	120–250	341	1324	1767	1933	712	317
GGT (U/L)	10–60	74	88	88	74	184	131
AKP (U/L)	45–125		84		122	205	155
AMY (U/L)	35–135	50.2	190	329	477	443	178
LPS (U/L)	1–54	137.6	382.7	398.5	406.7	565.2	263.6
Cr (U/L)	57–111	91	228	536	170	175	209
PT (S)	10–13.5		14.4	11.7	11.4	12.4	14.6
APTT (S)	23.9–33.5		53.9		25.4	23.7	26

Abbreviations: WBC, white blood cell; HB, hemoglobin; PLT, platelet; CRP, C-reactive protein; PCT, procalcitonin; T. BIL, total bilirubin; D. BIL, direct bilirubin; TBA, total bile acid; AST, aspartate aminotransferase; ALT, alanine aminotransferase; LDH, lactate dehydrogenase; GGT, gamma-glutamyl transpeptidase; AKP, alkaline phosphatase; AMY, amylase; LPS, lipase; Cr, creatinine; PT, prothrombin time; APTT, activated partial thromboplastin time.

Figure 1 Abdominal CT images of the patient. (A) Abdominal CT on June 25, 2022. The pancreas was swollen with effusion around the pancreas and both kidneys. (B) An MRCP image of the patient on July 1, 2022. The pancreas is enlarged, surrounding tissues were exudation, and the gallbladder is full, cholestasis. (C) Abdominal CT on July 5, 2022. Compared with the abdominal CT images on June 25, 2022, the exudation around pancreas and bilateral kidneys was obviously improved.

Figure 2 (A–D) Trend charts for key liver, pancreas, and kidney function indicators since the day (June 25, 2022) transferred to the intensive care unit (ICU).