Abstract
Central and peripheral hormone deficiencies have been documented during and after acute hantavirus infection. Thrombocytopenia and coagulation abnormalities are common findings in haemorrhagic fever with renal syndrome (HFRS). The associations between coagulation and hormonal abnormalities in HFRS have not been studied yet. Forty-two patients diagnosed with Puumala virus (PUUV) infection were examined during the acute phase and on a follow-up visit approximately one month later. Hormonal defects were common during acute PUUV infection. Overt (clinical) hypogonadism was identified in 80% of the men and approximately 20% of the patients had overt hypothyroidism. At the one-month follow-up visit, six patients had central hormone deficits. Acute peripheral hormone deficits associated with a more severe acute kidney injury (AKI), longer hospital stay and more severe thrombocytopenia. Half of the patients with bleeding symptoms had also peripheral hormonal deficiencies. Patients with free thyroxine levels below the reference range had higher D-dimer level than patients with normal thyroid function, but no thromboembolic events occurred. Acute phase hormonal abnormalities associate with severe disease and altered haemostasis in PUUV infection.
Highlights
Hantavirus infections present with two distinct clinical syndromes: a haemorrhagic fever with renal syndrome (HFRS) in Europe and Asia, and a hantavirus cardiopulmonary syndrome (HCPS) in North and South America [1]
In Finland the seroprevalence of Puumala virus (PUUV) infection in adult population is about 12.5% [3], and approximately
Hormonal defects were common during acute PUUV infection
Summary
Hantavirus infections present with two distinct clinical syndromes: a haemorrhagic fever with renal syndrome (HFRS) in Europe and Asia, and a hantavirus cardiopulmonary syndrome (HCPS) in North and South America [1]. PUUV is the most common hantavirus in Europe, causing a mild form of HFRS, called nephropathia epidemica [1,2]. In Finland the seroprevalence of PUUV infection in adult population is about 12.5% [3], and approximately. 1000–3000 serologically verified infections occur annually [1,2]. The clinical course of PUUV infection is usually mild but can vary from subclinical to fatal [2]. The typical symptoms of PUUV infection include fever, headache, visual disturbances, nausea, backache, and abdominal pain
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