Prospective study on ocular findings in acute Puumala hantavirus infection in hospitalised patients

Hautala, Nina; Kauma, Heikki; Vapalahti, Olli; Mähönen, Saara-Mari; Vainio, Olli; Vaheri, Antti; Hautala, Timo

doi:10.1136/bjo.2010.185413

Cited by 31 publications

(54 citation statements)

References 22 publications

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“…In addition, blood haemoglobin (Hb) concentration, thrombocyte count, blood white cell count (BWC), serum albumin concentration, plasma C-reactive protein (CRP) concentration, CSF glucose, protein and albumin concentrations, and CSF white cell count were determined. The patients were also examined by an ophthalmologist as described earlier [7]. In addition, the previously described results of brain magnetic resonance imaging (MRI), electroencephalography (EEG), and human leukocyte antigen (HLA) haplotyping were considered [6].…”

Section: Methodsmentioning

confidence: 99%

Elevated Cerebrospinal Fluid Neopterin Concentration Is Associated with Disease Severity in Acute Puumala Hantavirus Infection

Hautala

Partanen

Sironen

et al. 2013

Clinical and Developmental Immunology

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Nephropathia epidemica (NE) caused by Puumala hantavirus (PUUV) is the most common hemorrhagic fever with renal syndrome (HFRS) in Europe. The infection activates immunological mechanisms that contribute to the pathogenesis and characteristics of the illness. In this study we measured cerebrospinal fluid (CSF) neopterin concentration from 23 acute-phase NE patients. We collected data on kidney function, markers of tissue permeability, haemodynamic properties, blood cell count, length of hospitalisation, inflammatory parameters, and ophthalmological properties. The neopterin levels were elevated (>5.8 nmol/L) in 22 (96%) NE-patients (mean 45.8 nmol/L); these were especially high in patients with intrathecal PUUV-IgM production (mean 58.2 nmol/L, P = 0.01) and those with elevated CSF protein concentrations (mean 63.6 nmol/L, P < 0.05). We also observed a correlation between the neopterin and high plasma creatinine value (r = 0.66, P = 0.001), low blood thrombocyte count (r = −0.42, P < 0.05), and markedly disturbed refractory properties of an eye (r = 0.47, P < 0.05). Length of hospitalisation correlated with the neopterin (r = 0.42, P < 0.05; male patients r = 0.69, P < 0.01). Patients with signs of tissue oedema and increased permeability also had high neopterin concentrations. These results reinforce the view that PUUV-HFRS is a general infection that affects the central nervous system and the blood-brain barrier.

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Section: Methodsmentioning

confidence: 99%

Elevated Cerebrospinal Fluid Neopterin Concentration Is Associated with Disease Severity in Acute Puumala Hantavirus Infection

Hautala

Partanen

Sironen

et al. 2013

Clinical and Developmental Immunology

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“…Although 30-50% of PUUV-infected patients are hospitalized, the case-fatality rate is generally below 0.5% [37,42,43], but can be as high as 6.5% in older patients [42]. Blurred vision is one important diagnostic symptom in HFRS caused by PUUV [44]. Interestingly, it has become evident that PUUV infection may involve the CNS and the eye as well, and PUUV RNA and PUUV-specific IgM have been detected in cerebrospinal fluid [45][46][47].…”

Section: Hantavirus-caused Diseasesmentioning

confidence: 96%

Hantavirus protein interactions regulate cellular functions and signaling responses

Klingström

Ahlm

2011

Expert Review of Anti-infective Therapy

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“…60 Recently, 2 outbreaks of HFRS were reported in China in 2006 and 2010. 64,65 However, a case of acute glaucoma has also been reported. 61 A specific ocular association has been recognized with nephropathia epidemica a type of HFRS caused by the Puumala virus.…”

Section: Hantavirusmentioning

confidence: 99%

“…62Y64 Myopic shift associated with Puumala virus infection is explained by the ability of the virus to multiply within capillary endothelial cells, leading to increased vascular permeability. 64,65 The visual disturbances are only partially explained by the myopic shift, and hence, the ocular findings may be of multifactorial origin. 64,65 However, a case of acute glaucoma has also been reported.…”

Section: Hantavirusmentioning

confidence: 99%

Ocular Pathology

Ranjan¹,

Ranjan²

2014

Asia-Pacific Journal of Ophthalmology

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The role of viral infections in ocular pathology varies greatly, involving all the components of the eye. Some viruses like herpes simplex, herpes zoster, adenovirus, enterovirus 70, influenza virus, human immunodeficiency virus, and cytomegalovirus are well-known for their role in ocular pathology. In recent years, emerging and resurging viral infections represent an important public health problem. The Asia-Pacific region has witnessed a number of pandemic and epidemic outbreaks caused by these viruses during the last 2 decades. The number of ocular complications being reported in patients of these viral infections has also increased significantly during this period. Ophthalmologists and physicians should be aware of ocular manifestations of newly emerging or resurging viral diseases. We conducted a review of the literature published during the last 20 years with the objectives of finding out outbreaks of emerging and reemerging viruses in the Asia-Pacific region and finding out any ocular involvement in these viral infections. An iterative search of the MEDLINE and the Google databases was made using the search terms emerging virus, ocular manifestations, ocular complications, Chikungunya, Dengue, Japanese encephalitis, West Nile fever, Kyasanur forest disease, Rift valley fever, Hantavirus, Henipavirus, Influenza virus, Enterovirus 71, and Asia-Pacific region, separately and with reported ocular involvement in combination. This review article discusses the epidemiology and the systemic and ocular manifestations of all emerging viral infections with reported ocular involvement in the Asia-Pacific region.

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Prospective study on ocular findings in acute Puumala hantavirus infection in hospitalised patients

Cited by 31 publications

References 22 publications

Elevated Cerebrospinal Fluid Neopterin Concentration Is Associated with Disease Severity in Acute Puumala Hantavirus Infection

Elevated Cerebrospinal Fluid Neopterin Concentration Is Associated with Disease Severity in Acute Puumala Hantavirus Infection

Hantavirus protein interactions regulate cellular functions and signaling responses

Ocular Pathology

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