title: Hypophyseal hemorrhage and panhypopituitarism during Puumala Virus Infection: Magnetic Resonance Imaging and detection of viral antigen in the hypophysis.
abstract: We describe 3 cases of nephropathia epidemica (NE) that confirm that Puumala virus infection may cause hypophyseal injury. Autopsy revealed a hemorrhagic hypophysis positive for Puumala virus antigen in both neuroendocrine stromal and vascular endothelial cells in 1 patient, and 2 patients developed hypophyseal hemorrhage (diagnosed with magnetic resonance imaging) during or shortly after acute NE, both of whom developed panhypopituitarism.
authors.affiliation: Department of Internal Medicine, University of Oulu, Oulu, FIN-90014 Oulu, Finland. thautala@sun3.oulu.fi
authors.forename: Timo
authors.initials: T
authors.lastname: Hautala
authors.forename: Tarja
authors.initials: T
authors.lastname: Sironen
authors.forename: Olli
authors.initials: O
authors.lastname: Vapalahti
authors.forename: Eija
authors.initials: E
authors.lastname: Pääkkö
authors.forename: Terttu
authors.initials: T
authors.lastname: Särkioja
authors.forename: Pasi I
authors.initials: PI
authors.lastname: Salmela
authors.forename: Antti
authors.initials: A
authors.lastname: Vaheri
authors.forename: Alexander
authors.initials: A
authors.lastname: Plyusnin
authors.forename: Heikki
authors.initials: H
authors.lastname: Kauma
mesh_terms: D000328:Adult; D000956:Antigens, Viral / Q000032:analysis*; D006470:Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000821:virology; D006480:Hemorrhagic Fever with Renal Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007018:Hypopituitarism / Q000175:diagnosis* / Q000209:etiology / Q000821:virology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010900:Pituitary Diseases / Q000175:diagnosis / Q000209:etiology / Q000821:virology; D010902:Pituitary Gland / Q000821:virology*; D029262:Puumala virus
chemical_list: D000956:Antigens, Viral