Nephropathia epidemica in Finland: a retrospective study of 126 cases.
A total of 126 (99 males, 27 females) serologically confirmed hospital-treated adult cases of nephropathia epidemica (NE) were studied. The initial diagnosis suggested by the referring physician was correct in only 28%. Some rare clinical manifestations of NE were observed; acute myopericarditis in 3 patients and encephalitis in 1. Pulmonary involvement due to vascular congestion was observed in 16% and liver involvement in 34% of the patients. Thrombocytopenia was present in 75%, leukocytosis in 50% and anemia in 50%. Erythrocyte sedimentation rate (ESR) was 2-108 (mean 38) mm/h and C-reactive protein (CRP) 0-126 (mean 52) mg/l. Proteinuria was observed in 94%, hematuria in 58% and pyuria in 28%. Electrolyte abnormalities (hyponatremia, hypokalemia, hypocalcemia, hyperphosphatemia) were all common but rarely serious. Serum lipid changes caused by the acute infection and renal failure included very low total and HDL-cholesterol as well as high triglyceride levels. Renal function was transiently impaired in 94% of the patients and 7 needed transient dialysis therapy. All recovered.
Mustonen
J
J
Department of Clinical Medicine, University of Tampere, Finland.
Brummer-Korvenkontio
M
M
Hedman
K
K
Pasternack
A
A
Pietilä
K
K
Vaheri
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D004660:Encephalitis / Q000150:complications; D005260:Female; D005387:Finland; D006476:Orthohantavirus / Q000302:isolation & purification*; D006480:Hemorrhagic Fever with Renal Syndrome / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies