Hantaan Virus Infection with Acute Renal Failure

Abstract

We report on 10 patients with acute renal involvement in Hantaan virus infection observed at the Department of Nephrology, Faculty of Medicine, Skopje, Republic of Macedonia, during a period of 3 years (October 1987-July 1990). Eight patients were male and 2 were female, aged 37.5 +/- 4.8 years. The diagnosis of Hantaan virus infection was proven by an indirect immunofluorescent and ELISA test with a significant increase of the titer after a week to ranges from 1:512 to 1:2,048. Percutaneous renal biopsy was performed in 3 cases using standard procedures for optical and immunofluorescent microscopy. Fever, weakness, headache, conjunctival injection, hematuria, and lumbar pain were clinical features all patients had in common. Complete anuria was noted in 7 out of 10 and oliguria in the other 3 of the 10 cases with serum levels of creatinine 967 +/- 152.6 mumol/L. Other following laboratory findings were leukocytosis in 10 out of 10 patients, with neutrophylia, and reduction of serum sodium and potassium in 8 out of 10, and a decrease in serum complement C3 in 3 out of 10 patients. Percutaneous renal biopsy confirmed interstitionephritis in 2 out of 3 biopsied patients and acute diffuse proliferative glomerulonephritis in the third. Interstitial mononuclear infiltration with dominant T cells proven with monoclonal antisera (direct immunoperoxidase method) was present in all 3 cases. The outcome of the disease was good in 8 of the 10 patients with a development of polyuric phase and complete recovery of renal function later. One patient with interstitial lesions on biopsy developed chronic renal failure, and the other with a concomitant brucellosis died during the polyuric phase of the disease.

A case report of crescentic glomerulonephritis associated with Hantaan virus infection

“…Although it has been reported that serum C3 levels were decreased in some patients with interstitial nephritis associated with Hantaan virus infection [6], the hypocomplementaemia observed in our patient strongly suggested that crescent formation was mediated by an immune mechanism. This is the first report of a patient with immune complex-mediated crescentic GN associated with Hantaan virus infection.…”

“…Although only a few cases of glomerulonephritis (GN), including diffuse proliferative and mesangiocapillary GN, have been reported [5][6][7], an association between hantavirus infection and crescentic GN has not been described. Herein, we report a case of immune complex-mediated crescentic GN in a patient with Hantaan virus infection.…”

Genetic Characterization of Hantaviruses Transmitted by the Korean Field Mouse (Apodemus peninsulae), Far East Russia

“…2) from Primorye region, we detected pathologic changes typical of severe HFRS caused by hantavirus infection (32–35). We also detected and sequenced the partial M segment in the spleen of the same patient.…”

Comparison of the effects of Puumala and Dobrava viruses on early and long-term renal outcomes in patients with haemorrhagic fever with renal syndrome

“…found some tubulointerstitial changes in patients with a history of HFRS and concluded that their nature remained unknown 10 . Other authors have found sporadic cases of chronic deterioration of kidney function in patients with a severe form of the disease 11,12 . Others reported sporadic cases of chronic renal failure and the requirement for haemodialysis 13…”

“…It has been known for years that DOBV virus affects patients more severely than PUUV virus 3,14 . Therefore, they should receive more attention and should be considered candidates for dialysis on time 11,15 …”