[Febrile cytolysis disclosing hemorrhagic fever with renal syndrome].

We report the case of a 40-year-old-man who developed febrile cytolysis as the presenting sign of hemorragic fever with renal syndrome (HFRS). On admission, he had fever (40 degrees C) and epigastric pain. The AST level was at 2N, the ALT at 3N. There was a thrombocytopenia (61 000/mm(3)) without anemia or hyperleukocytosis. Three days after admission, the platelet count decreased to 40 000/mm(3), serum urea and creatinine increased from normal rate to 10.8mmol/l, 204.0 micromol/l, respectively. The HIV, HBV, HCV, leptospirosis antibodies were negative. The Hantavirus serology was positive (Ig G: 1/512). This case suggests that HFRS should be entertained as a possible cause of cytolysis with thrombocytopenia in patients with fever and no initial sign of renal involvement in North-Eastern France.