Efficacy of Plasmapheresis in Severe Leptospirosis Case Ciddi Leptospiroz Olgusunda Plazmaferez Etkinliği

Creative Commons License

Singil S., ERSAN S., Mingsar G., Çelik D.

Anatolian Journal of General Medical Research, cilt.36, sa.1, ss.3-7, 2026 (Scopus, TRDizin)

Özet

This study highlighted the efficacy of therapeutic plasma exchange and hemodialysis in a case of leptospirosis presenting with severe acute kidney injury. Leptospirosis is a zoonosis caused by spirochetes; it is more common in the tropics. It can be asymptomatic or present across a broad clinical spectrum, which may lead to mortality. A physically active 84-year-old male patient with a history of hypertension and prostate cancer, was admitted to our hospital with complaints of decreased oral intake for a week, weakness in the lower extremities, and subsequently developed a cough, fever, and jaundice. The patient was conscious, less cooperative than usual or expected, and appeared unwell on physical examination. His blood pressure was 155/94 mmHg, and he had tachycardia (111/min). The sclerae were icteric, and the conjunctivae were pale. Except for the presence of rales at lung bases, other systemic examinations were normal. Laboratory evaluation revealed anemia, thrombocytopenia, hyperbilirubinemia, and increased creatinine levels. Detection of risk factors for leptospirosis transmission in the patient’s history, recreational activities such as long forest walks and consumption of contaminated raw vegetables, and compatible clinical findings suggested Weil’s disease as the preliminary diagnosis. Leptospira polymerase chain reaction positivity in the urine confirmed the diagnosis. The patient developed oliguria during the course, and we started renal replacement therapy. The emergence of alveolar hemorrhage prompted us to apply plasmapheresis as rescue therapy. We achieved a dramatic renal recovery after ensuring diuresis with two sessions of plasmapheresis. Plasmapheresis as a rescue therapy successfully manages leptospirosis cases that present with multi-organ involvement, with high mortality.