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Volume 358:312-313 January 17, 2008 Number 3
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Case 31-2007: A Man with Abdominal Pain and Elevated Creatinine

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by Rabb, H.
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To the Editor: In the Case Record of a 41-year old man with acute renal failure, discussed by Rabb and Colvin (Oct. 11 issue),1 kidney biopsy revealed lesions that the discussants ascribe to nonsteroidal antiinflammatory drugs in association with dehydration. However, several observations remain unexplained: first, the low platelet count; second, the increased serum levels of lactate dehydrogenase; and third, the severe abdominal pain. Of note, the patient was a visitor from a Western European country. An important differential diagnosis of acute renal failure in Europe is nephropathia epidemica, caused by Puumala virus infection. A hallmark of the disease is . . . [Full Text of this Article]



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