Epidemic nephropathy in children.
Epidemic nephropathy, a form of hemorrhagic fever with renal syndrome, caused by the Puumala serotype of hantaviruses and occurring endemically in northern Scandinavia, was studied in 13 children. The clinical symptoms and signs were somewhat different from those reported in adults; none of our patients had hemorrhagic manifestations despite low thrombocyte counts. The most common presenting symptoms were fever, abdominal pain, and renal tenderness with oliguria followed by polyuria. The predominant laboratory findings were proteinuria and/or hematuria and elevated serum creatinine levels. Thrombocytopenia was a constant finding in the children in whom thrombocyte count was obtained. Most children had a decreased serum sodium concentration during the oliguric phase of the disease. All the children recovered, with no long-term renal disease. Epidemic nephropathy is an important alternative for differential diagnosis in children with findings suggesting nephritis, especially in endemic areas. An awareness and knowledge of this syndrome and an ability to diagnose it by means of a specific antibody measurement will probably improve our understanding of its epidemiologic features in children.
Department of Pediatrics, University of Oulu, Finland.
P
P
Lautala
M
M
Uhari
D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D002097:C-Reactive Protein / Q000737:chemistry; D002648:Child; D003404:Creatinine / Q000097:blood; D003937:Diagnosis, Differential; D005387:Finland / Q000453:epidemiology; D006480:Hemorrhagic Fever with Renal Syndrome / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D009395:Nephritis, Interstitial / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D011379:Prognosis; D011507:Proteinuria / Q000209:etiology / Q000652:urine; D012621:Seasons; D012964:Sodium / Q000097:blood; D013921:Thrombocytopenia / Q000097:blood / Q000209:etiology
D002097:C-Reactive Protein; D012964:Sodium; D003404:Creatinine; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase