PMC4097360_01
Gradual recovery of renal function.. Plasma creatinine and urea levels and urine output during the disease course and applied treatment show significant improvement of renal function by the end of CVVHD and plasmapheresis and normal function is restored in the 4th week of disease without the evidence of permanent damage.
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Renal function had completely recovered by the 25th day of disease ( Figure 1).
Extreme leukocytosis during the second week of disease indicated a high intensity of systemic inflammation, as the WBC correlated with LDH plasma levels.. Plasmapheresis enabled the clearance of proinflammatory factors as the WBC and LDH level normalized during and after this course of treatment. Red lines denote upper reference limit in our laboratory - for plasma LDH 485 IU/L and WBC 10x10
9/L.
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This trend was correlated with the values of LDH plasma levels ( Figure 2).
CT scan of thorax recorded on the 15th day of disease: massive left-sided hemothorax with atelectatic lung (arrow) that eventually required surgical treatment, as well as a careful strategy of protective invasive mechanical ventilation.
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A CT scan of the thorax performed on teh 15th day of disease revealed a massive left-sided hemothorax complicated by compressive and obstructive atelectasis of the left lung ( Figure 3).
MRI scan of brain recorded on the 12th day of disease: bilateral hyperintensity in lateral thalamic regions (arrows).
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An MRI scan of the brain recorded on the 12th day of disease revealed areas of raised signal in the pons, bilaterally in lateral parts of the thalamus ( Figure 4), as well as in the right external capsule and the left internal capsule.
MRI scan of abdomen obtained on the 12th day of disease: edematous jejunal wall and distension with air fluid level in caecum (arrows).
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An MRI of the abdomen performed on the 12th day of disease showed an edematous intestinal wall and distension of the jejunum, ileum and colon ascendens with several air fluid levels ( Figure 5).