Hanta hemorrhagic fever with renal syndrome: A pathology in whose diagnosis kidney biopsy plays a major role (Review)

Abstract

Hantavirus infection belongs to a group of zoonoses rare in the Balkan Peninsula, causing two major syndromes, depending on the viral serotype involved: Hemorrhagic fever with renal syndrome (HFRS) also known as endemic nephropathy and cardiopulmonary syndrome (CPS). Because there is no specific treatment or vaccine for this condition approved in the USA or Europe, the key to minimizing the risk of adverse progression to chronic kidney disease, secondary hypertension or even death is primarily the recognition and early diagnosis of this condition with prompt therapeutic intervention. The aim of this study was to review the literature data on the epidemiology, pathogenesis and management of this disease and to identify several aspects related to the difficulties encountered in diagnosing this pathology, taking into consideration that the disease is not endemic in this geographical area.

A patient with dialysis-dependent acute kidney injury due to hantavirus complicated with SARS-CoV-2 infection

“…Compromised barrier function and increased capillary leakage may be associated with proteinuria [ 9 ], while glycosuria can result from proximal tubular damage, whose severity can vary from mild tubular dysfunction to disturbances typical of Fanconi syndrome [ 10 ]; both features were present in our patient and can be attributed to hantavirus-associated kidney injury with glomerular and tubular involvement. Clinical symptoms of typical HFRS include fever, myalgias, headache, abdominal pain, vomiting, and hemorrhagic complications due to thrombocytopenia (gastrointestinal bleeding, hematuria), oliguria, and hypotensive shock [ 1 , 2 , 4 , 7 ]. The diagnosis of acute hantavirus infection is based on immunofluorescence and ELISA methods [ 11 ].…”

“…Hantavirus infections cause two clinical syndromes in humans: hemorrhagic fever with renal syndrome (HFRS) in Asia and Europe, and hantavirus pulmonary (or cardiopulmonary) syndrome (HPS) in the Americas, with fatality rates of up to 12 and 60%, respectively [ 1 ]. HFRS is characterized by fever and flu-like symptoms, AKI with oligoanuria, pyuria, severe thrombocytopenia, left-shifted leukocytosis, anemia, and coagulation dysfunction mimicking thrombotic microangiopathies, which may progress to hemorrhagic shock [ 2 ]. Depending on the virus strain that is endemic in different geographic locations, the clinical presentation ranges from mild to severe [ 2 ].…”

“…HFRS is characterized by fever and flu-like symptoms, AKI with oligoanuria, pyuria, severe thrombocytopenia, left-shifted leukocytosis, anemia, and coagulation dysfunction mimicking thrombotic microangiopathies, which may progress to hemorrhagic shock [ 2 ]. Depending on the virus strain that is endemic in different geographic locations, the clinical presentation ranges from mild to severe [ 2 ].…”

Hemorrhagic Fevers: Antiviral Effects and Molecular Targets of Biologically Active Polysaccharides and Lectins from Marine Aquatic Organisms

“…Ортохантовирусы (Bunyavirales: Hantaviridae, Orthohantavirus) вызывают две клинические формы вирусных ГЛ: геморрагическую лихорадку с почечным синдромом (ГЛПС), регистрирующуюся в Европе и Азии [5, 3,53], и хантавирусный кардиопульмонарный синдром в Америке [5,54]. Ежегодно в мире регистрируется от 150000 до 200000 случаев ГЛПС [55,56], большая часть из них происходит в Азии, в основном, в Китае [57]. На Дальнем Востоке России ежегодная заболеваемость ГЛПС обусловлена двумя ортохантавирусами: Хантаан и Сеул [58].…”

Differential Cytokine Responses and the Clinical Severity of Adult and Pediatric Nephropathia Epidemica

“…There are two phases of AKI, namely oliguric and polyuric [ 19 ]. The oliguric phase is characterized by decreased urine output, which in some patients could develop into transient anuria, a lack of urine output.…”