[Puumala virus infection (nephropathia epidemica) as different diagnosis of acute renal failure].
Puumala virus infection (nephropathia epidemica) as different diagnosis of acute renal failure.


METHODS
A 34-year old patient presented in reduced status with a sudden onset of fever, headache, backpain, abdominal pain, mild diarrhea, nausea with vomiting, and blurred vision. Within a few days an acute renal failure developed.


METHODS
On admittance there was thrombocytopenia of 27/nl, CRP of 109 mg/l and proteinuria of 5 g/l, moderate glucosuria and erythrocyturia of 250/microliter. Renal biopsy showed acute hemorrhagic interstitial nephritis. DIAGNOSIS, THERAPY AND FOLLOW UP: Diagnosis of nephropathia epidemica was proven by puumala-virus IgM- and later IgG-antibodies. Hantaan-antibodies were negative. Maximum serum creatinine of 640 micromol/l and urea of 30.5 mmol/l developed on the 5(th) day after admission. Without specific therapy the patient recovered fast and there were no persisting abnormalities during a 2-year follow up.


CONCLUSIONS
In young patients with acute renal failure of unknown origin with the above symptoms hantavirus-infection with the subtypes puumala and dobrava should be considered in Central Europe.
Stockmann
M
M
Medizinische Klinik I Gastroenterologie, Infektiologie und Rheumatologie, Germany.
Stöffler-Meilicke
M
M
Schwarz
A
A
Pohly
M
M
Scherübl
H
H
D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000473:pathology; D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D001706:Biopsy; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006480:Hemorrhagic Fever with Renal Syndrome / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D007668:Kidney / Q000473:pathology; D008297:Male; D029262:Puumala virus; D013997:Time Factors
D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M