Beechnuts and outbreaks of nephropathia epidemica (NE): of mast, mice and men

Clément, Jan; Maes, Piet; Strihou, Charles van Ypersele de; Groen, G van der; Barrios, José Miguel; Verstraeten, Willem; Ranst, Marc Van

doi:10.1093/ndt/gfq122

Cited by 50 publications

(61 citation statements)

References 30 publications

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“…In Finland 1,000-3,000 cases of PUUV infection are serologically diagnosed every year, making this nation the most endemic country in the world for the prevalence of hantavirus infections. Moreover, the high annual average incidence of 31/100,000 clearly surpasses most of the other single causes of acute kidney injury (AKI) that have been considered in the Kidney Disease: Improving Global Outcomes (KDIGO) criteria (http://www3.ktl.fi) [8,9,10]. Other countries besides Finland, where the total number of all recorded PUUV cases during the years 1979-2006 exceeded 1,000, include Russia, Sweden, Belgium, France, Germany, and Norway [8].…”

Section: Introductionmentioning

confidence: 99%

Community Acquired Severe Acute Kidney Injury Caused by Hantavirus-Induced Hemorrhagic Fever with Renal Syndrome Has a Favorable Outcome

Outinen¹,

Mäkelä²,

Clément³

et al. 2015

Nephron

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Background: Puumala hantavirus (PUUV) induces an acute tubulointerstitial nephritis and acute kidney injury (AKI). Our aim was to evaluate the prognosis of severe AKI associated with PUUV infection. Methods: We examined 556 patients who were treated at Tampere University Hospital during 1982-2013 for acute, serologically confirmed PUUV infection. Plasma creatinine was measured during hospitalization, convalescence, and 1, 2, and 5 years after the acute infection. Results: Plasma creatinine concentration was elevated (>100 μmol/l) in 459 (83%) patients, while altogether 189 patients (34%) had severe AKI defined as Kidney Disease: Improving Global Outcomes (KDIGO) stage 3, that is, plasma creatinine ≥353.6 μmol/l (4.0 mg/dl) or need of dialysis. There were no fatal cases during the hospitalization or the following 3 months. Fatality rate during the years following PUUV infection did not differ between patients who had suffered from severe AKI versus those without severe AKI. Post-hospitalization plasma creatinine values were available for 188 (34%) patients. One month after the acute infection, patients with prior severe AKI had higher median plasma creatinine concentration (82 µmol/l, range 54-184) than patients without severe AKI (74 µmol/l, range 55-109, p = 0.005). After 1 year, no significant difference existed in median plasma creatinine concentrations between patients with (71 µmol/l, range 36-123) and without prior severe AKI (72 µmol/l, range 34-116, p = 0.711). After 5 years all but 1 patient had normal creatinine levels. Conclusions: In contrast to the worldwide well-accepted KDIGO criteria, severe AKI associated with PUUV infection is not associated with excess fatality but has a very good prognosis, both in the short and long terms.

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Section: Introductionmentioning

confidence: 99%

Community Acquired Severe Acute Kidney Injury Caused by Hantavirus-Induced Hemorrhagic Fever with Renal Syndrome Has a Favorable Outcome

Outinen¹,

Mäkelä²,

Clément³

et al. 2015

Nephron

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Section: Differenzialdiagnosen Und Weitere Diagnostikunclassified

“…Die Hantavirusinfektion kommt als einziges hämorrha-gisches Fieber weltweit vor [5]. Von den bisher 22 verschiedenen Hantavirusspezies ist jede mit einem bestimmten Trä-ger verbunden [5]. So wird der Puumalavirus von der Wühlmaus übertragen, bei der bis zu 20% der Tiere als infektiös gelten und ein hämorrhagisches Fieber mit renaler Beteiligung auslösen können.…”

Section: Differenzialdiagnosen Und Weitere Diagnostikunclassified

“…Manche Patienten sind auch komplett asymptomatisch. Es wird geschätzt, dass nur 13% der Hantavirusinfektionen als solche diagnostiziert werden [5]. Das Puumalavirus, der in Europa und Deutschland am häu-figsten anzutreffende Stamm, verursacht im Regelfall -verglichen mit den anderen Hantavirusspezies -eine relativ milde Erkrankung [5]; sie kann sich mit abdominellen Schmerzen, Fieber, Kopfschmerzen, Übelkeit und Erbrechen sowie typischerweise Sehstörungen präsen-tieren [10].…”

Section: Differenzialdiagnosen Und Weitere Diagnostikunclassified

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Akute Nierenschädigung bei einer 47-jährigen Patientin

2014

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“…The dominant biotope in Finland is the boreal coniferous forest or taiga, in contrast to the deciduous broad-leaf forests in Western Europe. However, the PUUV reservoir in both regions is a rodent from the family Cricetidae, the bank vole or Myodes glareolus, a common small mammal in both forest biotopes [5]. So, the strongest risk factor linked to housing and/or living environment might be in fact the distance of the human habitat or working place to the forest, an element again not examined in the study of Vapalahti et al Indeed, living <50 m from the forest emerged as a risk factor for NE (adjusted OR 1 .…”

Section: Smoking and Other Risk Factors For Hantavirus Infections : Tmentioning

confidence: 99%