title: Clinical course and long-term outcome of hantavirus-associated nephropathia epidemica, Germany.
abstract: Human infection with Puumala virus (PUUV), the most common hantavirus in Central Europe, causes nephropathia epidemica (NE), a disease characterized by acute kidney injury and thrombocytopenia. To determine the clinical phenotype of hantavirus-infected patients and their long-term outcome and humoral immunity to PUUV, we conducted a cross-sectional prospective survey of 456 patients in Germany with clinically and serologically confirmed hantavirus-associated NE during 2001-2012. Prominent clinical findings during acute NE were fever and back/limb pain, and 88% of the patients had acute kidney injury. At follow-up (7-35 mo), all patients had detectable hantavirus-specific IgG; 8.5% had persistent IgM; 25% had hematuria; 23% had hypertension (new diagnosis for 67%); and 7% had proteinuria. NE-associated hypertension and proteinuria do not appear to have long-term consequences, but NE-associated hematuria may. All patients in this study had hantavirus-specific IgG up to years after the infection.
authors.forename: Joerg
authors.initials: J
authors.lastname: Latus
authors.forename: Matthias
authors.initials: M
authors.lastname: Schwab
authors.forename: Evelina
authors.initials: E
authors.lastname: Tacconelli
authors.forename: Friedrich-Michael
authors.initials: FM
authors.lastname: Pieper
authors.forename: Daniel
authors.initials: D
authors.lastname: Wegener
authors.forename: Juergen
authors.initials: J
authors.lastname: Dippon
authors.forename: Simon
authors.initials: S
authors.lastname: Müller
authors.forename: David
authors.initials: D
authors.lastname: Zakim
authors.forename: Stephan
authors.initials: S
authors.lastname: Segerer
authors.forename: Daniel
authors.initials: D
authors.lastname: Kitterer
authors.forename: Martin
authors.initials: M
authors.lastname: Priwitzer
authors.forename: Barbara
authors.initials: B
authors.lastname: Mezger
authors.forename: Birgit
authors.initials: B
authors.lastname: Walter-Frank
authors.forename: Angela
authors.initials: A
authors.lastname: Corea
authors.forename: Albrecht
authors.initials: A
authors.lastname: Wiedenmann
authors.forename: Stefan
authors.initials: S
authors.lastname: Brockmann
authors.forename: Christoph
authors.initials: C
authors.lastname: Pöhlmann
authors.forename: M Dominik
authors.initials: MD
authors.lastname: Alscher
authors.forename: Niko
authors.initials: N
authors.lastname: Braun
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany; D006417:Hematuria / Q000821:virology; D006480:Hemorrhagic Fever with Renal Syndrome / Q000276:immunology* / Q000503:physiopathology / Q000652:urine / Q000821:virology; D006801:Humans; D006973:Hypertension / Q000821:virology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies