J Korean Med Sci.  2010 Aug;25(8):1244-1246. 10.3346/jkms.2010.25.8.1244.

Reversible Splenium Lesion of the Corpus Callosum in Hemorrhagic Fever with Renal Failure Syndrome

• Baek SH
• Shin DI
• Lee HS
• Lee SH
• Kim HY
• Shin KS
• Lee SY
• Han HS
• Han HJ
• Lee SS

• KMID: 1714053
• DOI: http://doi.org/10.3346/jkms.2010.25.8.1244

Abstract

This is the first case of virus-associated encephalitis/encephalopathy in which the pathogen was Hantaan virus. A 53-yr-old man presented fever, renal failure and a hemorrhagic tendency and he was diagnosed with hemorrhagic fever with renal failure syndrome (HFRS). In the course of his illness, mild neurologic symptoms such as dizziness and confusion developed and magnetic resonance images revealed a reversible lesion in the splenium of the corpus callosum. This case suggests that HFRS patients with neurologic symptoms like dizziness and mental slowing should be considered to have structural brain lesions and to require brain imaging studies.

Keyword

Hemorrhagic Fever with Renal Failure Syndrome; Hantaan virus; Reversible Splenium Lesion

MeSH Terms

Antibodies, Viral/blood
Corpus Callosum/*pathology
Diagnosis, Differential
Hantaan virus/immunology
Hemorrhagic Fever with Renal Syndrome/*diagnosis/therapy
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Platelet Count
Renal Dialysis

Figure

• 

  Fig. 1 Initial MRI. Diffusion-weighted images (A) show a high signal intensity in the splenium of the corpus callosum (SCC). ADC map images (B) at the same level show a low ADC, reflecting restricted diffusion. T2-weighted images (C) reveal increased signal intensity in the SCC lesion with slightly decreased signal intensity on T1-weigted images (D).

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  Fig. 2 Serial change of platelet count.

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  Fig. 3 Serial change of blood creatinine.

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  Fig. 4 Follow-up MRI obtained 14 days later. The images correspond to those in Fig. 1 and show complete resolution of the SCC lesion with no residual changes.

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