title: Delayed onset of diuresis in a patient with acute renal failure due to hemorrhagic fever with renal syndrome who also developed anterior hypopituitarism.
abstract: A 23-year-old man developed acute renal failure (ARF) due to hemorrhagic fever with renal syndrome (HFRS). The patient also developed anterior hypopituitarism as a complication of HFRS. The patient's oliguric phase was very much prolonged for over 10 days before the diuresis began. The urine output during the oliguric phase was near anuric (< 50 ml/day). Interestingly, the patient began to diurese just after the institution of glucocorticoid and thyroid hormone replacement therapy. The plasma atrial natriuretic polypeptide went up to a smaller peak (150.0 pg/ml) at the onset of diuresis compared with 15 other patients (292.4 +/- 190.4 pg/ml) who did not develop anterior hypopituitarism. The delayed onset of diuresis and smaller increase of plasma ANP may have a causal relationship with the patient's hypopituitarism.
authors.affiliation: Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: J E
authors.initials: JE
authors.lastname: Park
authors.forename: H J
authors.initials: HJ
authors.lastname: Pyo
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000652:urine / Q000821:virology*; D000328:Adult; D009320:Atrial Natriuretic Factor / Q000097:blood; D004231:Diuresis; D006480:Hemorrhagic Fever with Renal Syndrome / Q000097:blood / Q000150:complications* / Q000652:urine; D006801:Humans; D007018:Hypopituitarism / Q000097:blood / Q000652:urine / Q000821:virology*; D008297:Male; D010903:Pituitary Gland, Anterior / Q000473:pathology*; D011863:Radioimmunoassay; D012083:Renin / Q000097:blood
chemical_list: D009320:Atrial Natriuretic Factor; D012083:Renin