Acute liver failure due to leptospirosis successfully treated with MARS (molecular adsorbent recirculating system) dialysis

Background Leptospirosis is a re-emerging infectious disease, which may lead to multiple organ failure (MOF)and death. Case presentation We report the first case of severe leptospirosis complicated with acute renal and liver failure, successfully treated with albumin dialysis––molecular adsorbent recirculating system (MARS). Despite antibiotic therapy, optimum medical supportive treatment and timely initiated haemodialysis, the outcome was complicated by severe liver failure: hepatic encephalopathy grade III, hypoglycemia, prominent hyperbilirubinemia (TBIL 31.3 mg/dl, DBIL 28.6 mg/dl)and hepatic cytolysis (ALT 535 IU/l, AST 179 IU/l) and prolongation of the prothrombine time (68.4 sec). The patient underwent two sesions of albumin dialysis with the MARS procedure with complete recovery of hepatic and renal function. Conclusion Albumin dialysis may confer a significant survival benefit on patients with leptospirosis-induced acute liver failure (ALF).