title: Mild course of Puumala nephropathy in children in an area with sporadic occurrence Hantavirus infection.
abstract: The first three children with Puumala virus nephropathy diagnosis in the Czech Republic are reported on. A boy and two girls were admitted with symptoms of interstitial nephritis. The medical history in all children revealed flu-like symptoms. All patients were mildly pyrexial and had elevated erythrocytes sedimentation rate, C-reactive protein and low hemoglobin levels. Serum creatinine levels were elevated and proteinuria exceeded 700 mg/L in all children. Tubular proteinuria, glycosuria, high urinary N-acetyl-beta-D-glucosaminidase levels and alpha-1-microglobulin levels confirmed the tubular lesion. Renal biopsies revealed a uniform pattern and showed non-purulent interstitial nephritis in all patients. Puumala virus antigen antibodies were detected in the plasma. All patients were treated with steroids and urine abnormalities and renal function returned to normal within 4 weeks. Hantavirus infection should be considered as one of possible causes of interstitial nephritis with decreased GFR in children even in areas with a low incidence of this infection.
authors.affiliation: Department of Pediatrics, 2nd Medical School, Charles University, Prague and University Hospital Motol, V Uvalu 84, 150 06, Prague 5, Czech Republic. j.dusek@lfmotol.cuni.cz
authors.forename: Jirí
authors.initials: J
authors.lastname: Dusek
authors.forename: Milan
authors.initials: M
authors.lastname: Pejcoch
authors.forename: Alexander
authors.initials: A
authors.lastname: Kolsky
authors.forename: Tomas
authors.initials: T
authors.lastname: Seeman
authors.forename: Vladimir
authors.initials: V
authors.lastname: Nemec
authors.forename: Josef
authors.initials: J
authors.lastname: Stejskal
authors.forename: Karel
authors.initials: K
authors.lastname: Vondrak
authors.forename: Jan
authors.initials: J
authors.lastname: Janda
mesh_terms: D000293:Adolescent; D002648:Child; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D006476:Orthohantavirus; D018778:Hantavirus Infections / Q000175:diagnosis / Q000453:epidemiology*; D006480:Hemorrhagic Fever with Renal Syndrome / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008297:Male; D029262:Puumala virus