deamino-arginine-vasopressin and Hemorrhagic-Fever-with-Renal-Syndrome

Central diabetes insipidus (DI) was detected in a patient with hemorrhagic fever with renal syndrome (HFRS) who had been molecularly and serologically diagnosed with Hantaan virus infection. We recommend that clinicians differentiate central DI in HFRS patients with a persistent diuretic phase even when pituitary MRI findings are normal.

Topics: Deamino Arginine Vasopressin; Diabetes Insipidus, Neurogenic; Hantaan virus; Hemorrhagic Fever with Renal Syndrome; Humans; Hypopituitarism; Magnetic Resonance Imaging; Male; Middle Aged; Phylogeny; Thyroxine

Glomerular filtration rate (GFR) and tubular involvement were studied in 74 patients with serologically verified nephropathia epidemica (NE). Increased levels of serum creatinine and serum beta 2-microglobulin were documented in 96% and 99% of the patients, respectively. The mean of the lowest estimated GFR was 26 ml/min. Proximal tubular reabsorptive capacity was assessed by urinary loss of beta 2-microglobulin and cell damage by urinary activity of N-acetyl-beta-D-glucosaminidase. Both of these parameters were elevated in most of the patients during the acute phase of the disease. Increased serum levels of Tamm-Horsfall-specific IgG and/or IgA occurred in 72 of 74 patients. No patient required dialysis and there was no mortality. Six months after discharge only three patients had a GFR less than 80 ml/min as estimated by [51Cr]EDTA clearance; two of these had underlying chronic diseases and one had suffered clinically severe NE. Desmopressin tests showed decreased urine osmolarity in three patients 8 months after discharge. These three had chronic diseases, which may have contributed to the impaired tubular function. Thus, there was a markedly decreased GFR and a tubular dysfunction in the acute phase of NE. Most patients recovered within a few months and none showed evidence of chronically impaired renal function due to NE.

Topics: Acetylglucosaminidase; Acute Disease; Adolescent; Adult; Aged; beta 2-Microglobulin; Chronic Disease; Creatinine; Deamino Arginine Vasopressin; Female; Glomerular Filtration Rate; Hemorrhagic Fever with Renal Syndrome; Humans; Immunoglobulin A; Immunoglobulin G; Kidney Tubules; Male; Middle Aged; Mucoproteins; Osmolar Concentration; Uromodulin

Topics: Deamino Arginine Vasopressin; Hemorrhagic Fever with Renal Syndrome; Humans; Kidney Diseases