Hemorrhagic fever with renal syndrome associated with acute pancreatitis

Puca, Edmond; Pilaca, Arben; Pipero, Pellumb; Kraja, Dhimitër; Puca, Entela

doi:10.1007/s12250-012-3231-3

Cited by 14 publications

(18 citation statements)

References 6 publications

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“…We observed elevated levels of lipase and P-amylase in the patient infected with DOBV-Sochi, indicating a possible hantavirus-related acute pancreatitis. The association of HFRS with acute pancreatitis was described for several cases of infection with Dobrava-Belgrade and Hantaan virus [22–24], but not for infections with Puumala virus [25]. …”

Section: Case Presentationmentioning

confidence: 99%

Clinical characterization of two severe cases of hemorrhagic fever with renal syndrome (HFRS) caused by hantaviruses Puumala and Dobrava-Belgrade genotype Sochi

et al. 2016

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BackgroundHantavirus disease belongs to the emerging infections. The clinical picture and severity of infections differ between hantavirus species and may even vary between hantavirus genotypes. The mechanisms that lead to the broad variance of severity in infected patients are not completely understood. Host- and virus-specific factors are considered.Case presentationWe analyzed severe cases of hantavirus disease in two young women. The first case was caused by Puumala virus (PUUV) infection in Germany; the second case describes the infection with Dobrava-Belgrade virus (DOBV) in Russia. Symptoms, laboratory parameters and cytokine levels were analyzed and compared between the two patients. Serological and sequence analysis revealed that PUUV was the infecting agent for the German patient and the infection of the Russian patient was caused by Dobrava-Belgrade virus genotype Sochi (DOBV-Sochi). The symptoms in the initial phase of the diseases did not differ noticeably between both patients. However, deterioration of laboratory parameter values was prolonged and stronger in DOBV-Sochi than in PUUV infection. Circulating endothelial progenitor cells (cEPCs), known to be responsible for endothelial repair, were mobilized in both infections. Striking differences were observed in the temporal course and level of cytokine upregulation. Levels of angiopoietin-2 (Ang-2), vascular endothelial growth factor (VEGF), and stromal derived factor-1 (SDF-1α) were increased in both infections; but, sustained and more pronounced elevation was observed in DOBV-Sochi infection.ConclusionsSevere hantavirus disease caused by different hantavirus species did not differ in the general symptoms and clinical characteristics. However, we observed a prolonged clinical course and a late and enhanced mobilization of cytokines in DOBV-Sochi infection. The differences in cytokine deregulation may contribute to the observed variation in the clinical course.

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Section: Case Presentationmentioning

confidence: 99%

Clinical characterization of two severe cases of hemorrhagic fever with renal syndrome (HFRS) caused by hantaviruses Puumala and Dobrava-Belgrade genotype Sochi

et al. 2016

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“…Other reports indicate that AP develops in 2.8% to 54% of patients with HFRS depending on geographic location [8][9][10]. This is the first Albanian study that presents the frequency of AP as a complication of the HFRS, however a case report of AP in a patient with HFRS in Albania has been previously published [4]. All patients with AP experienced abdominal pain as the main symptom, fever, nausea and vomiting were also observed.…”

Section: Discussionmentioning

confidence: 69%

“…Hantaviruses cause two diseases, typified by HFRS in Eurasia and hantavirus cardio-pulmonary syndrome (HCPS) in the Americas. Hantaviruses are usually transmitted to humans through aerosolized excrements from rodents, rodents are assymptomatic carriers with lifelong infections [1][2][3][4]. The physiopathology of hantavirus infection is not completely understood, however capillary endothelium injury occurs which increases vascular permeability.…”

Section: Introductionmentioning

confidence: 99%

“…As a systemic pathology, HFRS can affect various systems in the body. The most common symptoms in patients with HFRS are fever, sweating, myalgia, lumbago, nausea and vomiting, headache, abdominal pain, blurred vision and oliguria, which is followed by polyuria in patients with a good prognosis [3,4,7,8]. The most commonly affected organ is the kidneys but other organs, such as the lungs, liver, heart, central nervous system, endocrine centers and gastrointestinal tract, may also be affected [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…The most commonly affected organ is the kidneys but other organs, such as the lungs, liver, heart, central nervous system, endocrine centers and gastrointestinal tract, may also be affected [7][8][9]. One of the most serious extrarenal injuries of HFRS, in terms of the gastrointestinal system, is acute pancreatitis (AP) [4][5][6][7][8][9][10]. AP has a serious pathology, with rapid clinical presentation which has been associated with high mortality [7].…”

Section: Introductionmentioning

confidence: 99%

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Pancreatitis in patients with hemorrhagic fever with renal syndrome: A five-year experience

Puca¹,

Harxhi²,

Pipero³

et al. 2017

J Infect Dev Ctries

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Introduction: Pancreatitis is a rare complication of hemorrhagic fever with renal syndrome (HFRS). The causative agents of HFRS are hantaviruses, which belong to the genus Hantavirus, family Bunyaviridae. The purpose of this study was to evaluate cases of acute pancreatitis (AP) in patients with HFRS at the Service of Infectious Diseases, Tirana, Albania. Methodology: In this retrospective study, clinical and laboratory data was obtained from 36 patients with confirmed HFRS, between January 2011 and December 2016. The diagnosis had been confirmed by a positive enzyme-linked immunosorbent assay (ELISA) for IgM or IgG antibodies to hantavirus. Results: The average patient age was 39.7 ± 14.1 years with a range of 15-59 years. From 36 HFRS patients, four (11.1%) were found to have AP, all were male. Abdominal pain was the most common symptom and an increase in amylase and lipase was observed in all four patients. Abdominal computed tomography (CT) indicated pancreatitis with surrounding edema, necrosis and hemorrhage. In this study, the total mortality was 11.1% (4/36), while mortality in patients with AP was 25% (1/4). Conclusions: The results indicate that AP is a serious complication of HFRS, with a poor prognosis. Increased awareness of AP in clinicians and assessment of amylasemia or lipasemia in patients with HFRS should be considered, especially in endemic areas where a rapid diagnosis is crucial for a positive outcome.

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Genetic detection of hantaviruses in rodents, Albania

et al. 2016

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In order to have a first insight into the epidemiology of hantaviruses in Albania, 263 small mammals (248 rodents, 15 insectivores) were captured in 352 locations in 29 districts and tested for hantavirus infection. Dobrava-Belgrade virus (DOBV) was detected in 10 of 148 (6.7%) Apodemus flavicollis rodents. DOBV-positive A. flavicollis were detected in six districts (Diber, Korce, Kolonje, Librazhd, Pogradec, and Vlore). The obtained nucleotide sequences were highly similar to each other and to DOBV sequences from northwestern Greece. Understanding the epidemiology of hantaviruses and identifying the endemic foci enables the public health strategies to minimize the risk of human infection. J. Med. Virol. 88:1309-1313, 2016. © 2016 Wiley Periodicals, Inc.

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Hemorrhagic fever with renal syndrome associated with acute pancreatitis

Cited by 14 publications

References 6 publications

Clinical characterization of two severe cases of hemorrhagic fever with renal syndrome (HFRS) caused by hantaviruses Puumala and Dobrava-Belgrade genotype Sochi

Clinical characterization of two severe cases of hemorrhagic fever with renal syndrome (HFRS) caused by hantaviruses Puumala and Dobrava-Belgrade genotype Sochi

Pancreatitis in patients with hemorrhagic fever with renal syndrome: A five-year experience

Genetic detection of hantaviruses in rodents, Albania

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