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  • Title: [Puumala virus infection (nephropathia epidemica) as different diagnosis of acute renal failure].
    Author: Stockmann M, Stöffler-Meilicke M, Schwarz A, Pohly M, Scherübl H.
    Journal: Dtsch Med Wochenschr; 2002 Mar 15; 127(11):557-60. PubMed ID: 11894176.
    Abstract:
    UNLABELLED: Puumala virus infection (nephropathia epidemica) as different diagnosis of acute renal failure. HISTORY: A 34-year old patient presented in reduced status with a sudden onset of fever, headache, backpain, abdominal pain, mild diarrhea, nausea with vomiting, and blurred vision. Within a few days an acute renal failure developed. INVESTIGATIONS: On admittance there was thrombocytopenia of 27/nl, CRP of 109 mg/l and proteinuria of 5 g/l, moderate glucosuria and erythrocyturia of 250/microliter. Renal biopsy showed acute hemorrhagic interstitial nephritis. DIAGNOSIS, THERAPY AND FOLLOW UP: Diagnosis of nephropathia epidemica was proven by puumala-virus IgM- and later IgG-antibodies. Hantaan-antibodies were negative. Maximum serum creatinine of 640 micromol/l and urea of 30.5 mmol/l developed on the 5(th) day after admission. Without specific therapy the patient recovered fast and there were no persisting abnormalities during a 2-year follow up. CONCLUSION: In young patients with acute renal failure of unknown origin with the above symptoms hantavirus-infection with the subtypes puumala and dobrava should be considered in Central Europe.
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