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  • Title: More than half of the patients with acute Puumala hantavirus infection have abnormal cardiac findings.
    Author: Makela S, Kokkonen L, Ala-Houhala I, Groundstroem K, Harmoinen A, Huhtala H, Hurme M, Paakkala A, Porsti I, Virtanen V, Vaheri A, Mustonen J.
    Journal: Scand J Infect Dis; 2009; 41(1):57-62. PubMed ID: 18932105.
    Abstract:
    This study was conducted to determine the frequency, severity and outcome of cardiac findings in patients with acute Puumala hantavirus-induced nephropathia epidemica (NE). 70 consecutive, hospital-treated patients with serologically confirmed NE were prospectively examined using serial electrocardiograms (ECG), plasma troponin I, tumour necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6), and echocardiography (ECHO). Examinations were repeated after 3 and 12 months. ECG changes were observed in 57% of patients. Plasma troponin I levels remained normal in all. In six patients, ECHO showed left ventricular contraction abnormalities, and 1 patient had mild pericardial effusion. There were no differences in clinical or standard laboratory findings or in plasma TNF-alpha and IL-6 concentrations between patients with and without ECG or ECHO changes. During the follow-up, all acute-phase changes in ECG and ECHO reverted to normal, which probably reflects their benign nature. We conclude that abnormal cardiac findings are surprisingly common during NE.
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