Systemic Inflammation in Hemorrhagic Fever with Renal Syndrome Correlates with Hypotension and Thrombocytopenia but Not with Renal Injury

• Published in: The Journal of infectious diseases Vol. 181; no. 6; pp. 1964 - 1970
• Main Authors: Takala, Annika, Lähdevirta, Juhani, Jansson, Sten-Erik, Vapalahti, Olli, Orpana, Arto, Karonen, Sirkka-Liisa, Repo, Heikki
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.06.2000; University of Chicago Press; Oxford University Press
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; E-Selectin - analysis; Female; Hantavirus pulmonary syndrome; Hemorrhagic fever with renal syndrome; Hemorrhagic Fever with Renal Syndrome - complications; Hospital admissions; Human viral diseases; Humans; Hypotension - etiology; Infectious diseases; Inflammation; Inflammation - etiology; Kidney Diseases - etiology; Macrophage-1 Antigen - analysis; Major Article; Male; Medical sciences; Middle Aged; Monocytes; Neutrophils; Platelets; Receptors, Interleukin-2 - analysis; Rectangles; Respiratory insufficiency; Thrombocytopenia - etiology; Viral diseases; Viral diseases of the genital and urinary system; Viruses; Infection; Human; Thrombocytopenia; Platelet; Urinary system disease; Pathogenesis; Viral disease; Hemorrhagic fever with renal syndrome; Hemopathy; Inflammation
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/315522

Systemic inflammation is common in patients with nephropathia epidemica (NE), a European form of hemorrhagic fever. Markers of inflammation were studied in a patient with NE with respiratory insufficiency (patient 1), 18 other patients with NE, and 13 patients with a viral infectious disease other than NE. Neutrophil and monocyte CD11b expression levels, determined by flow cytometry; soluble interleukin (IL)-2 receptor (sIL-2R), IL-6, and IL-8 concentrations, determined by means of Immulite; and soluble E-selecrin, determined by ELISA, were higher in patients with NE than in healthy subjects. The findings were not specific for NE and did not correlate with serum creatinine levels, but the findings correlated inversely with mean arterial pressure (sIL-2R and monocyte CD11b expression) and minimum platelet count (sIL-2R, IL-6, neutrophil, and monocyte CD11b expression). Monocyte CD11b expression in patient 1 was extremely high, suggesting that monocytes may contribute to development of lung injury. Severity of inflammation in patients with NE is related to hypotension and platelet consumption but not to renal injury.