HEMORRHAGIC FEVER WITH RENAL SYNDROME AND COEXISTING PULMONARY SYNDROME: UNNUSUAL PRESENTATION OF HANTAVIRUS INFECTION
Date Issued
2024-04-04
Author(s)
Karanfilovsk, V
Suleyman, S
Trajceska L.
DOI
https://www.mzndtvo.com.mk/
Abstract
HEMORRHAGIC FEVER WITH RENAL SYNDROME
AND COEXISTING PULMONARY SYNDROME:
UNNUSUAL PRESENTATION OF HANTAVIRUS
INFECTION
V. Karanfilovski, S. Suleyman, Z. Janevski, N.
Gjorgjievski, Z. Sterjova Markovska, G. Severova, I. G.
Nikolov, L. Trajceska, I. Rambabova-Bushljetik and G.
Spasovski
University Clinic of Nephrology, Faculty of Medicine,
University Sts. Cyril and Methodius Skopje, N,
Macedonia
PP
Introduction. Hantavirus infections traditionally
presented in two distinct syndromes, the so-called
"Hemorrhagic Fever with Renal Syndrome" (HFRS)
with the kidneys as main target organs, in contrast to
"Hantavirus Pulmonary Syndrome" (HPS) with the
lungs as main target organs. However, the numbers of
reported HFRS cases with lung involvement and HPS
cases with renal and/or hemorrhagic involvement
are continuously growing, emphasizing the need to
reconsider the paradigm of two different syndromes.
Methods. We described two cases of young males
with Hantavirus infection who presented with fever,
abdominal pain, thrombocytopenia, hemorrhage and
acute kidney injury requiring hemodialysis treatment.
Both cases followed an atypical clinical course with
cardio-pulmonary affection and development of hypotension and acute respiratory distress syndrome
(ARDS) with need of mechanical ventilation in one of
the patients.
Results. Ultimately, both patients experienced gradual improvement of renal and cardio-pulmonary
function, and developed no chronic complications.
Conclusion. Both syndromes caused by Hantavirus
are immune-mediated and overactive immune response
and endothelial dysfunction in various organs could
lead to wide spectrum of clinical presentations and
overlapping syndromes. Hantavirus should be considered as a possible etiological factor in patient presenting with pulmonary-renal syndrome.
AND COEXISTING PULMONARY SYNDROME:
UNNUSUAL PRESENTATION OF HANTAVIRUS
INFECTION
V. Karanfilovski, S. Suleyman, Z. Janevski, N.
Gjorgjievski, Z. Sterjova Markovska, G. Severova, I. G.
Nikolov, L. Trajceska, I. Rambabova-Bushljetik and G.
Spasovski
University Clinic of Nephrology, Faculty of Medicine,
University Sts. Cyril and Methodius Skopje, N,
Macedonia
PP
Introduction. Hantavirus infections traditionally
presented in two distinct syndromes, the so-called
"Hemorrhagic Fever with Renal Syndrome" (HFRS)
with the kidneys as main target organs, in contrast to
"Hantavirus Pulmonary Syndrome" (HPS) with the
lungs as main target organs. However, the numbers of
reported HFRS cases with lung involvement and HPS
cases with renal and/or hemorrhagic involvement
are continuously growing, emphasizing the need to
reconsider the paradigm of two different syndromes.
Methods. We described two cases of young males
with Hantavirus infection who presented with fever,
abdominal pain, thrombocytopenia, hemorrhage and
acute kidney injury requiring hemodialysis treatment.
Both cases followed an atypical clinical course with
cardio-pulmonary affection and development of hypotension and acute respiratory distress syndrome
(ARDS) with need of mechanical ventilation in one of
the patients.
Results. Ultimately, both patients experienced gradual improvement of renal and cardio-pulmonary
function, and developed no chronic complications.
Conclusion. Both syndromes caused by Hantavirus
are immune-mediated and overactive immune response
and endothelial dysfunction in various organs could
lead to wide spectrum of clinical presentations and
overlapping syndromes. Hantavirus should be considered as a possible etiological factor in patient presenting with pulmonary-renal syndrome.
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