Single case of Weil's disease with marked hyperbilirubinemia and acute renal failure successfully treated with bilirubin adsorption and hemodialysis.

DOI 3 Citations 11 References
  • Ohashi Teiko
    Department of Nephrology, Chigasaki Tokusyukai Medical Center
  • Naito Masayo
    Department of Nephrology, Chigasaki Tokusyukai Medical Center
  • Kubota Kenji
    Department of Nephrology, Chigasaki Tokusyukai Medical Center

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  • 激烈な高ビリルビン血症，急性腎不全を呈し，ビリルビン吸着と血液透析により救命できたワイル病の１症例

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A 55-year old male farmer who had come into contact with rats while handling straw was examined at our hospital chiefly because of fever and jaundice. Symptoms indicative of acute renal failure were also noted, and the man was hospitalized. After admission, the patient presented with characteristic clinical symptoms such as a 40°C fever accompanied by shaking chills, hyperemic conjunctiva, and calf muscle pain. As the patient had been in contact with rats, Weil's disease was suspected.<br>The patient was immediately given 6 million units of benzylpenicillin potassium (PCG)/day and started on hemodialysis for the acute renal failure. His serum T-Bil was high, rising to 42.7mg/dL, so bilirubin adsorption therapy was conducted two times. Thereafter, the patient's blood test data and general condition gradually improved. On the 21th hospital day, PCG was discontinued, and the total number of hemodialysis sessions was 14. Leptospira was detected in urine culture and the patient was diagnosed as Weil's disease. Early treatment in Weil's disease strongly influences prognosis; a delay in treatment can result in a fatal outcome. Although this patient had severe leptospirosis, it appeared that he followed a favorable course because Weil's disease was suspected at an early stage and appropriate early treatment with antibiotics and hemodialysis, as well as bilirubin adsorption was given.

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