Mesangiocapillary glomerulonephritis caused by Puumala hantavirus infection.
Nephropathia epidemica induced by Puumala hantavirus typically causes acute reversible renal function impairment. A typical renal biopsy finding is acute tubulointerstitial nephritis with slight glomerular mesangial changes. We describe here 5 patients who developed the nephrotic syndrome during the convalescent phase of an otherwise typical acute febrile nephropathia epidemica. Renal biopsy of all patients disclosed type I mesangiocapillary glomerulonephritis (MCGN). A clinical remission of the nephrotic syndrome was observed in 4 patients during the follow-up period, and 1 entered into chronic renal failure. Three patients had microscopic hematuria and proteinuria and 2 elevated blood pressure at the latest assessment visit. No patient had clinical or laboratory findings compatible with chronic bacterial, parasitic or viral infections (hepatitis B or C), malignancies, or other disorders known to be associated with MCGN. In conclusion, Puumala hantavirus has to be added to the list of potential agents associated with type I MCGN. Further studies are necessary to establish the incidence of MCGN caused by various hantavirus infections.
Mustonen
J
J
Medical School, University of Tampere, Tampere, Finland. jukka.mustonen@uta.fi
Mäkelä
S
S
Helin
H
H
Helanterä
A
A
Miettinen
M
M
Partanen
J
J
Pasternack
A
A
D000328:Adult; D000368:Aged; D001706:Biopsy; D003176:Complement C3 / Q000032:analysis; D005260:Female; D015432:Glomerulonephritis, Membranoproliferative / Q000821:virology*; D006480:Hemorrhagic Fever with Renal Syndrome / Q000150:complications* / Q000473:pathology; D006801:Humans; D007678:Kidney Glomerulus / Q000737:chemistry / Q000473:pathology; D008297:Male; D008875:Middle Aged; D029262:Puumala virus
D003176:Complement C3