Febrile cytolysis due to hemorrhagic fever with renal syndrome

We report the case of a in-year-old-man who developed febrile cytolysis as the presenting sign of hemorragic fever with renal syndrome (HFRS). On admi ssion, he had fever (40 degreesC) and epigastric pain. The AST level was at 2N, the ALT at 3N. There was a thrombocytopenia (61 000/mm(3)) without ane mia or hyperleukocytosis. Three days after admission, the platelet count de creased to 40 000/mm(3) serum urea and creatinine increased from normal rat e to 10.8mmol/l, 204.0 mu mol/l, respectively. The HIV, HBV, HCV, leptospir osis antibodies were negative. The Hantavirus serology was positive (Ig G: 1/512). This case suggests that HFRS should be entertained as a possible ca use of cytolysis with thrombocytopenia in patients with fever and no initia l sign of renal involvement in North-Eastern France.