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2016 ; 16
(1
): 675
Nephropedia Template TP
gab.com Text
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English Wikipedia
Clinical characterization of two severe cases of hemorrhagic fever with renal
syndrome (HFRS) caused by hantaviruses Puumala and Dobrava-Belgrade genotype
Sochi
#MMPMID27842513
Krautkrämer E
; Nusshag C
; Baumann A
; Schäfer J
; Hofmann J
; Schnitzler P
; Klempa B
; Witkowski PT
; Krüger DH
; Zeier M
BMC Infect Dis
2016[Nov]; 16
(1
): 675
PMID27842513
show ga
BACKGROUND: Hantavirus disease belongs to the emerging infections. The clinical
picture and severity of infections differ between hantavirus species and may even
vary between hantavirus genotypes. The mechanisms that lead to the broad variance
of severity in infected patients are not completely understood. Host- and
virus-specific factors are considered. CASE PRESENTATION: We analyzed severe
cases of hantavirus disease in two young women. The first case was caused by
Puumala virus (PUUV) infection in Germany; the second case describes the
infection with Dobrava-Belgrade virus (DOBV) in Russia. Symptoms, laboratory
parameters and cytokine levels were analyzed and compared between the two
patients. Serological and sequence analysis revealed that PUUV was the infecting
agent for the German patient and the infection of the Russian patient was caused
by Dobrava-Belgrade virus genotype Sochi (DOBV-Sochi). The symptoms in the
initial phase of the diseases did not differ noticeably between both patients.
However, deterioration of laboratory parameter values was prolonged and stronger
in DOBV-Sochi than in PUUV infection. Circulating endothelial progenitor cells
(cEPCs), known to be responsible for endothelial repair, were mobilized in both
infections. Striking differences were observed in the temporal course and level
of cytokine upregulation. Levels of angiopoietin-2 (Ang-2), vascular endothelial
growth factor (VEGF), and stromal derived factor-1 (SDF-1?) were increased in
both infections; but, sustained and more pronounced elevation was observed in
DOBV-Sochi infection. CONCLUSIONS: Severe hantavirus disease caused by different
hantavirus species did not differ in the general symptoms and clinical
characteristics. However, we observed a prolonged clinical course and a late and
enhanced mobilization of cytokines in DOBV-Sochi infection. The differences in
cytokine deregulation may contribute to the observed variation in the clinical
course.
|*Genotype
[MESH]
|Adult
[MESH]
|Cytokines/genetics/metabolism
[MESH]
|Female
[MESH]
|Gene Expression Regulation
[MESH]
|Germany/epidemiology
[MESH]
|Hemorrhagic Fever with Renal Syndrome/epidemiology/*virology
[MESH]