[Acute kidney failure caused by Hantaviruses]

Area of Science:

• Infectious Diseases
• Nephrology
• Virology

Context:

• Hantavirus-induced acute renal failure, or Hemorrhagic Fever With Renal Syndrome (HFRS), is globally prevalent but underdiagnosed in Germany and Western Europe.
• Nephropathia epidemica (NE), the mild European HFRS form, presents with abrupt fever, pain, acute kidney injury, proteinuria, hematuria, polyuria, and thrombocytopenia.
• The vole-transmitted Puumula virus serotype is the etiological agent of NE, distinct from severe HFRS forms in Asia caused by Hantaan, Seoul, and Belgrade serotypes.

Purpose:

• To detail the clinical features, diagnosis, transmission, and management of Hantavirus-induced acute renal failure, specifically Nephropathia epidemica in Europe.
• To differentiate NE from more severe HFRS forms prevalent in Asia.
• To highlight diagnostic methods and risk factors associated with Hantavirus infections.

Summary:

• Nephropathia epidemica (NE) is characterized by acute renal failure and flu-like symptoms, primarily transmitted via airborne aerosols from infected voles.
• Diagnosis relies on serological evidence of IgG/IgM antibodies (IFA, ELISA) and clinical presentation, distinguishing it from other HFRS types.
• Treatment is symptomatic, focusing on pain management, diuresis, fluid/electrolyte balance, and potentially hemodialysis; renal biopsy shows acute interstitial nephritis.

Impact:

• Increases awareness of Hantavirus-induced kidney disease in non-endemic regions like Germany and Western Europe.
• Provides a clinical and diagnostic framework for identifying and managing Nephropathia epidemica.
• Emphasizes the importance of considering Hantavirus infection in patients with acute renal failure and relevant exposure history, particularly outdoor enthusiasts.