Hanta hemorrhagic fever with renal syndrome: A pathology in whose diagnosis kidney biopsy plays a major role (Review)
- Authors:
- Gabriela Lupuşoru
- Mircea Lupuşoru
- Ioana Ailincăi
- Lavinia Bernea
- Andreea Berechet
- Radu Spătaru
- Gener Ismail
-
Affiliations: Department of Nephrology, ‘Fundeni’ Clinical Institute, 022328 Bucharest, Romania, Department of Physiology I, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Pediatric Surgery, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania - Published online on: July 12, 2021 https://doi.org/10.3892/etm.2021.10416
- Article Number: 984
-
Copyright: © Lupuşoru et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
This article is mentioned in:
Abstract
 |
|
Zeier M, Handermann M, Bahr U, Rensch B, Muller S, Kehm R, Muranyi W and Darai G: New ecological aspects of hantavirus infection: A change of A paradigm and a challenge of prevention-a review. Virus Genes. 30:157–180. 2005.PubMed/NCBI View Article : Google Scholar | |
|
Avšič-Županc T, Saksida A and Korva M: Hantavirus infections. Clin Microbiol Infect. 21S:e6–e16. 2019.PubMed/NCBI View Article : Google Scholar | |
|
Satoskar A, Nadasdy T and Silva F: Acute postinfectious glomerulonephritis and glomerulonephritis caused by persistent bacterial infection. In Heptinstall's Pathology of the Kidney, 7th edition. Jannette JG, Olson JL, Silva FG and D'Agati VD (eds). Lippincott Williams and Wilkins, Philadelphia, pp678-798, 2015. | |
|
van Regenmortel MHV, Fauquet CM, Bishop DHL, Carstens EB, Estes MK, Lemon SM, Maniloff J, Mayo MA, McGeoch DJ, Pringle CR and Wickner RB (eds): Virus Taxonomy. Seventh Report of the International Committee on Taxonomy of Viruses. 1st edition. Academic Press, San Diego, San Francisco, New York, Boston, London, Sydney, Tokyo, 2000. | |
|
Lee HW, Lee PW and Johnson KM: Isolation of the etiologic agent of Korean hemorrhagic fever. J Infect Dis. 137:298–308. 1978.PubMed/NCBI View Article : Google Scholar | |
|
Vapalahti O, Mustonen J, Lundqvist Å, Henttonen H, Plyusnin A and Vaheri A: Hantavirus infections in Europe. Lancet Infect Dis. 3:653–661. 2003.PubMed/NCBI View Article : Google Scholar | |
|
Avsic-Zupanc T, Petrovec M, Furlan P, Kaps R, Elgh F and Lundkvist A: Hemorrhagic fever with renal syndrome in the Dolenjska region of Slovenia-a 10-year survey. Clin Infect Dis. 28:860–865. 1999.PubMed/NCBI View Article : Google Scholar | |
|
Steer A: Pathogenesis of renal changes in epidemic hemorrhagic fever. In: The Kidney. IAP Monograph. Mostofi FK and Smith DE (eds). Williams & Wilkins, Baltimore, pp476-486, 1996. | |
|
Jokinen EJ, Lähdevirta J and Collan Y: Nephropathia epidemica: Immunohistochemical study of pathogenesis. Clin Nephrol. 9:1–5. 1978.PubMed/NCBI | |
|
Zaki SR, Greer PW, Coffield LM, Goldsmith CS, Nolte KB, Foucar K, Feddersen RM, Zumvalt RE, Miller GL, Khan AS, et al: Hantavirus pulmonary syndrome: Pathogenesis of an emerging infectious disease. Am J Pathol. 146:552–579. 1995.PubMed/NCBI | |
|
Kim S, Kang ET, Kim YG, Han JS, Lee JS, Kim JI, Hall WC, Dalrymple JM and Peters CJ: Localization of Hantaan viral envelope glycoproteins by monoclonal antibodies in renal tissues from patients with Korean hemorrhagic fever H. Am J Clin Pathol. 100:398–403. 1993.PubMed/NCBI View Article : Google Scholar | |
|
Groen J, Bruijn JA, Gerding MN, Jordans JG, Moll van Charante AW and Osterhaus AD: Hantavirus antigen detection in kidney biopsies from patients with nephropathia epidemica. Clin Nephrol. 46:379–383. 1996.PubMed/NCBI | |
|
Poljak M and Avšič Županc T: Immunohistochemical detection of Hantaan virus antigen in renal tissue from patient with hemorrhagic fever with renal syndrome. Nephron. 67(252)1994.PubMed/NCBI View Article : Google Scholar | |
|
Padula PJ, Edelstein A, Miguel SD, López NM, Rossi CM and Rabinovich RD: Hantavirus pulmonary syndrome outbreak in Argentina: Molecular evidence for person-to-person transmission of Andes virus. Virology. 241:323–330. 1998.PubMed/NCBI View Article : Google Scholar | |
|
Martinez VP, Bellomo C, San Juan J, Pinna D, Forlenza R, Elder M and Padula PJ: Person-to-person transmission of Andes virus. Emerg Infect Dis. 11:1848–1853. 2005.PubMed/NCBI View Article : Google Scholar | |
|
European Centre for Disease Prevention and Control: https://www.ecdc.europa.eu/en/publications-data/hantavirus-infection-annual-epidemiological-report-2018. Accessed June 25, 2020. | |
|
Antoine M, Langlois ME, Bres E, Rabeyrin M, Reynes JM and Deeb A: Imported haemorrhagic fever with renal syndrome caused by Dobrava-Belgrade hantavirus in France. Clin Kidney J. 14:1014–1016. 2020.PubMed/NCBI View Article : Google Scholar | |
|
Shirai H, Yashima J, Tojimbara T and Honda K: Thrombotic microangiopathy caused by oral contraceptives in a kidney transplant recipient. Nephrology (Carlton). 21 (Suppl 1):S41–S43. 2016.PubMed/NCBI View Article : Google Scholar | |
|
Douron E, Moriniere B, Matheron S, Girard PM, Gonzalez JP, Hirsch F and McCormick JB: HFRS after a wild rodent bite in the Haute-Savoie- and risk of exposure to Hantaan-like virus in a Paris laboratory. Lancet. 1:676–677. 1984.PubMed/NCBI View Article : Google Scholar | |
|
Mustonen J, Partanen J, Kanerva M, Pietilä K, Vapalahti O, Pasternack A and Vaheri A: Genetic susceptibility to severe course of nephropathia epidemica caused by Puumala hantavirus. Kidney Int. 49:217–221. 1996.PubMed/NCBI View Article : Google Scholar | |
|
Mäkelä S, Mustonen J, Ala-Houhala I, Hurme M, Partanen J, Vapalahti O, Vaheri A and Pasternack A: Human leukocyte antigen-B8-DR3 is a more important risk factor for severe Puumala hantavirus infection than the tumor necrosis factor-alpha (308) G/A polymorphism. J Infect Dis. 186:843–846. 2002.PubMed/NCBI View Article : Google Scholar | |
|
Paakkala A, Mäkelä S, Hurme M, Partanen J, Huhtala H and Mustonen J: Association of chest radiography findings with hostrelated genetic factors in patients with nephropathia epidemica. Scand J Infect Dis. 40:254–258. 2008.PubMed/NCBI View Article : Google Scholar | |
|
Mustonen J, Partanen J, Kanerva M, Pietilä K, Vapalahti O, Pasternack A and Vaheri A: Association of HLA B27 with benign clinical course of nephropathia epidemica caused by Puumala hantavirus. Scand J Immunol. 47:277–279. 1998.PubMed/NCBI View Article : Google Scholar | |
|
Vaheri A, Henttonen H, Voutilainen L, Mustonen J, Sironen T and Vapalahti O: Hantavirus infections in Europe and their impact on public health. Rev Med Virol. 23:35–49. 2013.PubMed/NCBI View Article : Google Scholar | |
|
Gavrilovskaya IN, Gorbunova EE and Mackow ER: Pathogenic hantaviruses direct the adherence of quiescent platelets to infected endothelial cells. J Virol. 84:4832–4839. 2010.PubMed/NCBI View Article : Google Scholar | |
|
Gavrilovskaya IN, Brown EJ, Ginsberg MH and Mackow ER: Cellular entry of hantaviruses which cause hemorrhagic fever with renal syndrome is mediated by beta3 integrins. J Virol. 73:3951–3959. 1999.PubMed/NCBI View Article : Google Scholar | |
|
Krautkramer E, Grouls S, Stein N, Reiser J and Zeier M: Pathogenic old word hantaviruses infect renal glomerular and tubular cells and induce disassembling of cell-to-cell contacts. J Virol. 85:9811–9823. 2011.PubMed/NCBI View Article : Google Scholar | |
|
Boehlke C, Hartleben B, Huber T, Hopfer H, Walz G and Neumann-Haefelin E: Hantavirus infection with severe proteinuria and podocyte foot-process effacement. Am J Kidney Dis. 64:452–456. 2014.PubMed/NCBI View Article : Google Scholar | |
|
Krautkramer E, Zeier M and Plyusnin A: Hantavirus infection: An emerging infectious disease causing acute renal failure. Kidney Int. 83:23–27. 2013.PubMed/NCBI View Article : Google Scholar | |
|
Peebles RS Jr and Graham BS: Viruses, dendritic cells and the lung. Respir Res. 2:245–249. 2001.PubMed/NCBI View Article : Google Scholar | |
|
Schonrich G, Rang A, Lutteke N, Raftery MJ, Charbonnel N and Ulrich RG: Hantavirus-induced immunity in rodent reservoirs and humans. Immunol Rev. 225:163–189. 2008.PubMed/NCBI View Article : Google Scholar | |
|
Terajima M and Ennis FA: T cells and pathogenesis of hantavirus and cardiopulmonary syndrome and hemorrhagic fever with renal syndrome. Viruses. 3:1059–1073. 2011.PubMed/NCBI View Article : Google Scholar | |
|
Safronetz D, Zivcec M, Lacasse R, Feldmann F, Rosenke R, Long D, Haddock E, Brining D, Gardner D, Feldmann H and Ebihara H: Pathogenesis and host response in Syrian hamsters following intranasal infection with Andes virus. PLoS Pathog. 7(e1002426)2011.PubMed/NCBI View Article : Google Scholar | |
|
Saksida A, Wraber B and Avsic-Zupanc T: Serum levels of inflammatory and regulatory cytokines in patients with hemorrhagic fever with renal syndrome. BMC Infect Dis. 11(142)2011.PubMed/NCBI View Article : Google Scholar | |
|
Hägele S, Müller A, Nusshag C, Reiser J, Zeier M and Krautkrämer E: Motility of human renal cells is disturbed by infection with pathogenic hantaviruses. BMC Infect Dis. 18(645)2018.PubMed/NCBI View Article : Google Scholar | |
|
Mustonen J, Mäkelä S, Heli H, Helanterä A, Miettinen M, Partanen J and Pasternack A: Mesangiocapillary glomerulonephritis caused by Puumala hantavirus infection. Nephron. 89:402–407. 2001.PubMed/NCBI View Article : Google Scholar | |
|
Papadimitriou M: Hantavirus nephropathy. Kidnei Int. 48:887–902. 1995.PubMed/NCBI View Article : Google Scholar | |
|
Li XZ, Jin XM and Li H: Semi-thin sections and electron microscopy in epidemic hemorrhagic fever. Trans Harbin Med Univ. 3:43–46. 1984. | |
|
Clement J, Lee APK, Verpooten GA, Laenen L, Vergote V, De Samblanx H, Berneman ZN, Van Ranst M and Maes P: Acute hantavirus infection presenting as haemolytic-uraemic syndrome (HUS): The importance of early clinical diagnosis. Eur J Clin Microbiol Infect Dis. 37:135–140. 2018.PubMed/NCBI View Article : Google Scholar | |
|
Gheorghe G, Ceobanu G, Gheorghe F, Bratu OG, Bacalbasa N, Bungau S and Diaconu CC: Fever of unknown origin. Rom J Mil Med. 123(213)2020. | |
|
Hautala N, Kauma H, Vapalahti O, Mähönen SM, Vainio O, Vaheri A and Hautala T: Prospective study on ocular findings in acute Puumala hantavirus infection in hospitalised patients. Br J Ophthalmol. 95:559–562. 2011.PubMed/NCBI View Article : Google Scholar | |
|
McCaughey C and Hart CA: Hantaviruses. J Med Microbiol. 49:587–599. 2000.PubMed/NCBI View Article : Google Scholar | |
|
Linderholm M and Elgh F: Clinical characteristics of hantavirus infections on the Eurasian continent. Curr Top Microbiol Immunol. 256:135–151. 2001.PubMed/NCBI View Article : Google Scholar | |
|
Kruger DH, Ulrich R and Lundkvist AA: Hantavirus infections and their prevention. Microbes Infect. 3:1129–1144. 2001.PubMed/NCBI View Article : Google Scholar | |
|
Jereb M, Lunacek NK, Kotar T, Saksida A, Petrovec M and Avsic-Zupanc T: Procalcitonin in hantavirus infections. Scand J Clin Lab Invest. 71:287–291. 2011.PubMed/NCBI View Article : Google Scholar | |
|
Outinen TK, Mäkelä SM, Ala-Houhala IO, Huhtala HS, Hurme M, Paakkala AS, Pörsti IH, Syrjänen JT and Mustonen JT: The severity of Puumala hantavirus induced nephropathia epidemica can be better evaluated using plasma interleukin-6 than C-reactive protein determinations. BMC Infect Dis. 10(132)2010.PubMed/NCBI View Article : Google Scholar | |
|
Mäkelä S, Mustonen J, Ala-Houhala I, Hurme M, Koivisto AM, Vaheri A and Pasternack A: Urinary excretion of interleukin-6 correlates with proteinuria in acute Puumala hantavirus-induced nephritis. Am J Kidney Dis. 43:809–816. 2004.PubMed/NCBI View Article : Google Scholar | |
|
Paakkala A, Mustonen J, Viander M, Huhtala H and Pasternack A: Complement activation in nephropathia epidemica caused by Puumala hantavirus. Clin Nephrol. 53:424–431. 2000.PubMed/NCBI | |
|
Sane J, Laine O, Mäkelä S, Paakkala A, Jarva H, Mustonen J, Vapalahti O, Meri A and Vaheri A: Complement activation in Puumala hantavirus infection correlates with disease severity. Ann Med. 44:468–475. 2012.PubMed/NCBI View Article : Google Scholar | |
|
Laine O, Mäkelä S, Mustonen J, Huhtala H, Szanto T, Vaheri A, Lassila R and Joutsi-Korhonen L: Enhanced thrombin formation and fibrinolysis during acute Puumala hantavirus infection. Thromb Res. 126:154–158. 2010.PubMed/NCBI View Article : Google Scholar | |
|
Wang M, Wang J, Wang T, Li J, Hui L and Ha X: Thrombocytopenia as a predictor of severe acute kidney injury in patients with Hantaan virus infections. PLoS One. 8(e53236)2013.PubMed/NCBI View Article : Google Scholar | |
|
Rasche FM, Uhel B, Krüger DH, Karges W, Czock D, Hampl W, Keller F, Meisel H and von Müller L: Thrombocytopenia and acute renal failure in Puumala hantavirus infections. Emerg Infect Dis. 10:420–425. 2004.PubMed/NCBI View Article : Google Scholar | |
|
Braun N, Haap M, Overkamp D, Kimmel M, Alscher MD, Lehnert H and Haas CS: Characterization and outcome following Puumala virus infection: A retrospective analysis of 75 cases. Nephrol Dial Transplant. 25:2997–3003. 2010.PubMed/NCBI View Article : Google Scholar | |
|
Hukic M, Valjevac A, Tulumovic D, Numanovic F and Heyman P: Pathogenicity and virulence of the present hantaviruses in Bosnia and Herzegovina: The impact on renal function. Eur J Clin Microbiol Infect Dis. 30:381–385. 2011.PubMed/NCBI View Article : Google Scholar | |
|
Clement J, Maes P, Lagrou K, Van Ranst M and Lameire N: A unifying hypothesis and a single name for a complex globally emerging infection: Hantavirus disease. Eur J Clin Microbiol Infect Dis. 31:1–5. 2012.PubMed/NCBI View Article : Google Scholar | |
|
Mäkelä S, Kokkonen L, Ala-Houhala I, Groundstroem K, Harmoinen A, Huhtala H, Hurme M, Paakkala A, Porsti I, Virtanen V, et al: More than half of the patients with acute Puumala hantavirus infection have abnormal cardiac findings. Scand J Infect Dis. 41:57–62. 2009.PubMed/NCBI View Article : Google Scholar | |
|
Mustonen J, Brummer-Korvenkontio M, Hedman K, Pasternack A, Pietilä K and Vaheri A: Nephropathia epidemica in Finland: A retrospective study of 126 cases. Scand J Infect Dis. 26:7–13. 1994.PubMed/NCBI View Article : Google Scholar | |
|
Bergmann F, Krone B, Bleich S, Prange H and Paulus W: Encephalitis due to a hantavirus infection. J Infect. 45:58–59. 2002.PubMed/NCBI View Article : Google Scholar | |
|
Ahlm C, Lindén C, Linderholm M, Alexeyev OA, Billhedent J, Elgh F, Fagerlund M, Zetterlund B and Settergren B: Central nervous system and ophthalmic involvement in nephropathia epidemica (European type of haemorrhagic fever with renal syndrome). J Infect. 36:149–155. 1998.PubMed/NCBI View Article : Google Scholar | |
|
Hautala T, Mähönen SM, Sironen T, Hautala N, Pääkkö E, Karttunen A, Salmela PI, Ilonen J, Vainio O, Glumoff V, et al: Central nervous system-related symptoms and findings are common in acute Puumala hantavirus infection. Ann Med. 42:344–351. 2010.PubMed/NCBI View Article : Google Scholar | |
|
Launes J and Hautanen A: Nephropathia epidemica encephalitis. Acta Neurol Scand. 78:234–235. 1988.PubMed/NCBI View Article : Google Scholar | |
|
Alexeyev OA and Morozov VG: Neurological manifestations of hemorrhagic fever with renal syndrome caused by Puumala virus: Review of 811 cases. Clin Infect Dis. 20:255–258. 1995.PubMed/NCBI View Article : Google Scholar | |
|
Cerar D, Avsic-Zuapanc T, Jereb M and Strle F: Case report: Severe neurological manifestation of Dobrava hantavirus infection. J Med Virol. 79:1841–1843. 2007.PubMed/NCBI View Article : Google Scholar | |
|
Settergren B, Boman J, Linderholm M, Wiström J, Hägg E and Arvidsson PA: A case of nephropathia epidemica associated with panhypopituitarism and nephrotic syndrome. Nephron. 61:234–235. 1992.PubMed/NCBI View Article : Google Scholar | |
|
Kilit TP, Kilit C and Erarslan S: A rare cause of acute pancreatitis: Hantavirus infection. Acta Gastroenterol Belg. 80:59–61. 2017.PubMed/NCBI | |
|
Hoier S, Aberle SW, Langner C, Schnedl W, Högenauer C, Reisinger EC, Krejs GJ and Krause R: Puumala virus RNA in patient with multiorgan failure. Emerg Infect Dis. 12:356–357. 2006.PubMed/NCBI View Article : Google Scholar | |
|
Miettinen MH, Makela SM, Ala-Houhala IO, Huhtala HS, Koobi T, Vaheri AI, Pasternack AI, Porsti IH and Mustonen JT: Tubular proteinuria and glomerular filtration 6 years after Puumala hantavirus-induced acute interstitial nephritis. Nephron Clin Pract. 112:c115–c120. 2009.PubMed/NCBI View Article : Google Scholar | |
|
Miettinen M, Mäkelä S, Haapala M, Helanterä A, Helin H, Vänttinen T and Mustonen J: Glomerulonephritis emerging shortly after Puumala hantavirus infection: A report of 7 patients. Clin Nephrol. 75:550–556. 2011.PubMed/NCBI View Article : Google Scholar | |
|
Tulumovic D, Imamovic G, Mesic E, Hukic M, Tulumovic A, Imamovic A and Zerem E: Comparison of the effects of Puumala and Dobrava viruses on early and long-term renal outcomes in patients with haemorrhagic fever with renal syndrome. Nephrology (Carlton). 15:340–343. 2010.PubMed/NCBI View Article : Google Scholar | |
|
Mäkelä S, Jaatinen P, Miettinen M, Salmi J, Ala-Houhala I, Huhtala H, Hurme M, Pörsti I, Vaheri A and Mustonen J: Hormonal deficiencies during and after Puumala hantavirus infection. Eur J Clin Microbiol Infect Dis. 29:705–713. 2010.PubMed/NCBI View Article : Google Scholar | |
|
Pekic S, Cvijovic G, Stojanovic M, Kendereski A, Micic D and Popovic V: Hypopituitarism as a late complication of hemorrhagic fever. Endocrine. 26:79–82. 2005.PubMed/NCBI View Article : Google Scholar | |
|
Stojanovic M, Pekic S, Cvijovic G, Miljic D, Doknic M, Nikolic-Djurovic M, Micic D, Hrvacevic R, Nesic V and Popovic V: High risk of hypopituitarism in patients who recovered from hemorrhagic fever with renal syndrome. J Clin Endocrinol Metab. 93:2722–2728. 2008.PubMed/NCBI View Article : Google Scholar | |
|
Miettinen MH, Mäkelä SM, Ala-Houhala IO, Huhtala HS, Kööbi T, Vaheri AI, Pasternack AI, Pörsti IH and Mustonen JT: Ten-year prognosis of Puumala hantavirus-induced acute interstitial nephritis. Kidney Int. 69:2043–2048. 2006.PubMed/NCBI View Article : Google Scholar | |
|
Plyusnin A, Hörling J, Kanerva M, Mustonen J, Cheng Y, Partanen J, Vapalahti O, Kukkonen SK, Niemimaa J, Henttonen H, et al: Puumala hantavirus genome in patients with nephropathia epidemica: Correlation of PCR positivity with HLA haplotype and link to viral sequences in local rodents. J Clin Microbiol. 35:1090–1096. 1997.PubMed/NCBI View Article : Google Scholar | |
|
Evander M, Eriksson I, Pettersson L, Juto P, Ahlm C, Olsson GE, Bucht G and Allard A: Puumala hantavirus viremia diagnosed by real-time reverse transcriptase PCR using samples from patients with hemorrhagic fever and renal syndrome. J Clin Microbiol. 45:2491–2497. 2007.PubMed/NCBI View Article : Google Scholar | |
|
Saksida A, Duh D, Korva M and Avsic-Zupanc T: Dobrava virus RNA load in patients who have hemorrhagic fever with renal syndrome. J Infect Dis. 197:681–685. 2008.PubMed/NCBI View Article : Google Scholar | |
|
Xiao R, Yang S, Koster F, Ye C, Stidley C and Hjelle B: Sin Nombre viral RNA load in patients with hantavirus cardiopulmonary syndrome. J Infect Dis. 194:1403–1409. 2006.PubMed/NCBI View Article : Google Scholar | |
|
Laslo CL, Bacalbasa N, Ana MAS, Carsote M, Bungau S, Rus M, Bratu OG and Diaconu CC: New oral anticoagulants-possible extension to other indications (Review). Exp Ther Med. 20:2401–2405. 2020.PubMed/NCBI View Article : Google Scholar | |
|
Outinen TK, Mäkelä S, Clement J, Paakkala A, Pörsti I and Mustonen J: Community acquired severe acute kidney injury caused by hantavirus-induced hemorrhagic fever with renal syndrome has a favorable outcome. Nephron. 130:182–190. 2015.PubMed/NCBI View Article : Google Scholar | |
|
Huggins JW: Prospects for treatment of viral hemorrhagic fevers with ribavirin, a broad-spectrum antiviral drug. Rev Infect Dis. 11 (Suppl 4):S750–S761. 1989.PubMed/NCBI View Article : Google Scholar | |
|
Huggins JW, Hsiang CM, Cosgriff TM, Guang MY, Smith JI, Wu ZO, LeDuc JW, Zheng ZM, Meegan JM, Wang QN, et al: Prospective, double-blind, concurrent, placebo-controlled clinical trial of intravenous ribavirin therapy of hemorrhagic fever with renal syndrome. J Infect Dis. 164:1119–1127. 1991.PubMed/NCBI View Article : Google Scholar | |
|
Rusnak JM, Byrne WR, Chung KN, Gibbs PH, Kim TT, Boudreau EF, Cosgriff T, Pittman P, Kim KY, Erlichman MS, et al: Experience with intravenous ribavirin in the treatment of hemorrhagic fever with renal syndrome in Korea. Antiviral Res. 81:68–76. 2009.PubMed/NCBI View Article : Google Scholar | |
|
Antonen J, Leppänen I, Tenhunen J, Arvola P, Mäkelä S, Vaheri A and Mustonen J: A severe case of Puumala hantavirus infection successfully treated with bradykinin receptor antagonist icatibant. Scand J Infect Dis. 45:494–496. 2013.PubMed/NCBI View Article : Google Scholar | |
|
Sironen T, Sane J, Lokki ML, Meri S, Andersson LC, Hautala T, Kauma H, Vuorinen S, Rasmuson J, Evander M, et al: Fatal Puumala hantavirus disease: Involvement of complement activation and vascular leakage in the pathobiology. Open Forum Infect Dis. 4(ofx229)2017.PubMed/NCBI View Article : Google Scholar | |
|
Tapia M, Mansilla C, Jose TM and Vera M: Hantavirus pulmonary syndrome, clinical experience in diagnosis and treatment. Hospital Coyhaique-Chile. Rev Chil Infect. 17:258–269. 2000. | |
|
Vial PA, Valdivieso F, Ferres M, Riquelme R, Rioseco ML, Calvo M, Castillo C, Díaz R, Scholz L, Cuiza A, et al: High-dose intravenous methylprednisolone for hantavirus cardiopulmonary syndrome in Chile: A double-blind, randomized controlled clinical trial. Clin Infect Dis. 57:943–951. 2013.PubMed/NCBI View Article : Google Scholar |
