[Puumala virus infection (nephropathia epidemica) as different diagnosis of acute renal failure]

M Stockmann1, M Stöffler-Meilicke, A Schwarz

  • 1Medizinische Klinik I Gastroenterologie, Infektiologie und Rheumatologie, Germany.

Abstract

Insights

Puumala virus infection, also known as nephropathia epidemica, can cause acute renal failure in young adults. Early consideration of hantavirus infection is crucial for diagnosis and management.

Area of Science:

  • Infectious Diseases
  • Nephrology
  • Virology

Background:

  • Puumala virus infection (nephropathia epidemica) is a significant cause of acute kidney injury.
  • Hantavirus infections are endemic in parts of Central Europe.

Observation:

  • A 34-year-old patient presented with fever, headache, abdominal pain, and acute renal failure.
  • Initial investigations revealed thrombocytopenia, elevated CRP, proteinuria, glucosuria, and erythrocyturia.
  • Renal biopsy confirmed acute hemorrhagic interstitial nephritis.

Findings:

  • Diagnosis of nephropathia epidemica was confirmed by Puumala virus IgM and IgG antibodies.
  • The patient experienced severe acute kidney injury with peak creatinine of 640 µmol/l and urea of 30.5 mmol/l.
  • The patient recovered fully within 2 years without specific antiviral therapy.

Implications:

  • Hantavirus infection should be considered in the differential diagnosis of acute renal failure in young patients presenting with similar symptoms in Central Europe.
  • Prompt diagnosis can guide clinical management and potentially prevent complications.
  • Further research into Puumala virus pathogenesis and treatment is warranted.

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