J Med Cases

Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc

Journal website http://www.journalmc.org

Case Report

Volume 7, Number 10, October 2016, pages 435-440

A Case of Severe Fever With Thrombocytopenia Syndrome Accompanied by Self-Limiting Severe Proteinuria That Inversely Correlated With the Platelet Count

Figure

Figure 1. Clinical course of the patient.

Tables

**Table 1.** Laboratory Findings on Admission
Urinalysis (third day)		CK	78 U/L
Protein	2+	T-cho	170 mg/dL
Glucose	-	TG	52 mg/dL
Ketone bodies	-	TP	6.8 g/dL
Bilirubin	-	Alb	4.3 g/dL
Blood cell count		BUN	24.7 mg/dL
WBC	2,500/μL	Cr	1.09 mg/dL
Neu	78%	Na	139 mEq/L
Eos	0%	K	4.5 mEq/L
Baso	0%	Cl	102 mEq/L
Mono	11.40%	Glucose	104 mg/dL
Lym	10.60%	Serological test
RBC	469 × 10⁴/μL	CRP	0.0 mg/dL
Hb	15.3 g/dL	HBs Ag	-
Plt	12.9 × 10⁴/μL	HCV Ab	-
Blood chemistry		Hemostatic test (third day)
T-bil	0.4 mg/dL	PT	11.9 s
AST	19 U/L	PT%	96%
ALT	17 U/L	APTT	37 s
LDH	188 U/L	Fib	307 mg/dL
ALP	231 U/L	FDP	5.3 μg/mL
AMY	71 U/L

**Table 2.** Clinical Course of Laboratory Examinations
	First	Third	Fourth	Fifth	Sixth	Seventh	Eighth	Ninth	10th	12th	14th
WBC, /μL	2,500	1,500	1,300	1,100	4,000	3,300	4,700	4,900	4,900	4,600	6,300
Hb, g/dL	15.3	15.7	15.2	14.6	16.0	15.6	16.1	15.8	15.2	15.1	15.0
PLT, × 10⁴/μL (13.1 - 36.2)	12.9	8.9	6.5	5.6	6.0	4.9	4.1	4.5	6.1	14.8	24.0
AST, U/L (10 - 35)	19	47	86	185	740	572	350	262	197	124	63
ALT, U/L (5 - 40)	17	32	48	101	538	558	435	405	396	410	301
CK, U/L (40 - 200)	78	270	975	2,131	6,100	6,190	4,300	1,900	975	310	144
BUN, mg/dL (7 - 20)	24.7	28.5	20.6	19.2	16.6	17.2	16.1	14.2	14.4	18.5	19.6
Cr, mg/dL (0.5 - 1.1)	1.09	1.11	1.08	0.89	0.82	0.78	0.73	0.69	0.80	0.70	0.78
Ferritin, ng/mL (18.6 - 261)			1,258								550.7

**Table 3.** Blood Examination Associated With Nephritis
Blood examination	Value	Reference range
IC: immune complex; ANA: antinuclear antibody; ANCA: anti-neutrophil cytoplasmic antibody; RF: rheumatoid factor.
IgG, mg/dL	1,007	850 - 1,850	Fourth day
IgA, mg/dL	113	90 - 420	Fourth day
IgM, mg/dL	69	40 - 340	Fourth day
C3, mg/dL	114	70 - 130	14th day
C4, mg/dL	32	15 - 50	14th day
IC(C1Qq), μg/mL	< 1.5	0 - 3.0	Ninth day
CystatinC, mg/L	1.08	0.61 - 1.00	Ninth day
CystatinC, mg/L	0.92	0.61 - 1.00	14th day
ANA	< × 40	0 - 39	12th day
C-ANCA, U/mL	< 1.0	< 3.5	12th day
P-ANCA, U/mL	< 1.0	< 3.5	12th day
RF, IU/mL	Undetectable	< 15	14th day