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Glomerulonephritis emerging shortly after Puumala hantavirus infection: a report on 7 patients

M Miettinen1, S Mäkelä, M Haapala

  • 1Department of Internal Medicine, Central Hospital of Jyväskylä, Finland. marja.miettinen@ksshp.fi

Clinical Nephrology
|May 27, 2011
PubMed
Abstract

Insights

Nephropathia epidemica (NE), a Puumala (PUU) hantavirus infection, can rarely cause nephrotic syndrome. Glomerulonephritis in NE patients typically shows a favorable prognosis with remission achieved.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Virology

Background:

  • Nephropathia epidemica (NE), caused by Puumala (PUU) hantavirus, usually presents as mild hemorrhagic fever with acute tubulointerstitial nephritis.
  • Complete recovery is the typical outcome for NE patients.
  • Previous reports indicated a link between NE and membranoproliferative glomerulonephritis (MPGN).

Purpose of the Study:

  • To report on seven additional patients who developed biopsy-confirmed glomerulonephritis (GN) during the convalescent phase of NE.
  • To investigate the characteristics and outcomes of GN following PUU hantavirus infection.

Main Methods:

  • Case histories of seven patients with nephrotic-range proteinuria and hematuria after serologically verified NE were reviewed.
  • Renal biopsy specimens were analyzed to determine the type of glomerulonephritis.

Main Results:

  • Renal biopsies revealed MPGN in five patients, membranous GN (MGN) in one, and mesangial GN (MesGN) in one.
  • All seven patients achieved remission of their nephrotic syndrome.
  • Remission occurred within a median time of 0.6 years, with a median follow-up of 1.7 years.

Conclusions:

  • Nephrotic syndrome is a rare but recognized complication during the convalescent phase of acute PUU hantavirus infection.
  • The prognosis for glomerulonephritis associated with NE appears favorable in most cases.
  • Early diagnosis and management are crucial for favorable outcomes in NE-related kidney disease.

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