title: Evaluation of lipase levels in patients with nephropathia epidemica--no evidence for acute pancreatitis.
abstract: BACKGROUND
  The most common causative agent for hemorrhagic fever with renal syndrome in Germany is Puumala virus (PUUV) and a high percentage of patients with PUUV infection have gastrointestinal (GI) symptoms. The aim of the present study was to determine the prevalence of increased lipase levels and acute pancreatitis during nephropathia epidemica (NE) in 166 patients from Germany.
  
  
  METHODS
  Clinical and laboratory data during the acute phase of the disease were obtained from medical reports and files from 456 patients during acute hantavirus infection. Patients in whom serum lipase levels were determined during acute course of the disease were included in the study.
  
  
  RESULTS
  Lipase levels at the time of diagnosis were determined in 166 of the 456 NE patients (36%). Of the 166 patients, 25 (15%) had elevated lipase levels at the time of admission to hospital or first contact with general practitioner/nephrologist. In total 7 patients had a threefold increased serum lipase above the normal range. Abdominal pain was not more often present in the group of patients with elevated serum lipase compared to the lipase-negative group (9/25 vs 58/141). Abdominal ultrasound and CT scans revealed no signs of pancreatitis in any of the patients. Patients with elevated serum lipase had higher serum creatinine peak levels (p = 0.03) during the course of the disease.
  
  
  CONCLUSIONS
  Elevated lipase levels were common in our patient cohort and might reflect a more severe form of NE. NE does not lead to acute pancreatitis.
authors.affiliation: Department of Internal Medicine, Division of General Medicine and Nephrology, Robert-Bosch-Hospital, Auerbachstr. 110, 70376, Stuttgart, Germany. Daniel.kitterer@rbk.de.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kitterer
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, Diabetology, Vascular Disease, Nephrology and Clinical Chemistry, University of Tuebingen, Tuebingen, Germany. Ferruh.Artunc@med.uni-tuebingen.de.
authors.forename: Ferruh
authors.initials: F
authors.lastname: Artunc
authors.affiliation: Division of Nephrology, University Hospital, Zurich, Switzerland. Stephan.segerer@usz.ch.
authors.forename: Stephan
authors.initials: S
authors.lastname: Segerer
authors.affiliation: Department of Internal Medicine, Division of General Medicine and Nephrology, Robert-Bosch-Hospital, Auerbachstr. 110, 70376, Stuttgart, Germany. Dominik.alscher@rbk.de.
authors.forename: M Dominik
authors.initials: MD
authors.lastname: Alscher
authors.affiliation: Department of Internal Medicine, Division of General Medicine and Nephrology, Robert-Bosch-Hospital, Auerbachstr. 110, 70376, Stuttgart, Germany. Niko-braun@t-online.de.
authors.forename: Niko
authors.initials: N
authors.lastname: Braun
authors.affiliation: Department of Internal Medicine, Division of General Medicine and Nephrology, Robert-Bosch-Hospital, Auerbachstr. 110, 70376, Stuttgart, Germany. joerg.latus@rbk.de.
authors.forename: Joerg
authors.initials: J
authors.lastname: Latus
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D005260:Female; D005858:Germany / Q000453:epidemiology; D006476:Orthohantavirus / Q000302:isolation & purification; D018778:Hantavirus Infections / Q000097:blood / Q000150:complications / Q000453:epidemiology; D006480:Hemorrhagic Fever with Renal Syndrome / Q000097:blood* / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D008049:Lipase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood* / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D029262:Puumala virus / Q000302:isolation & purification
chemical_list: D008049:Lipase