Clinical profile and outcome of Hantavirus infection with renal involvement in India

Alok Kumar, Dorchhom Khrime, Nitin Bansal, Amar Nath Pandey, Shakeel Ahmad, Varma Amit

Abstract


Background:Hantavirus infections are found all over world but there is paucity of information about clinical features of Hantavirus infection in India.Aim of current study was to study clinical profile and outcome of patients with Hantavirus infection and renal insufficiency who presented at our institute.

Methods:All patients who were admitted in department of medicine with Hantavirus infection and renal insufficiency were included. Their basic demographic profile with relevant laboratory investigations was recorded. They were diagnosed with Hantavirus infection if they had positive IgM antibodies by ELISA test.

Results:There were seven patients with mean age of 54 years. They had mean serum creatinine level of 4.37 ± 1.86 mg%. All had thrombocytopenia and hepatic dysfunction as well. Five patients had hypotension. There was need of dialysis in three patients. They also had hypoalbuminemia. No patient had features suggestive of acute respiratory distress syndrome. All patients had recovery of renal function and there was no mortality.

Conclusion:Patients with Hantavirus infection presented like hemorrhagic fever with renal syndrome. Their outcome is good. We need to suspect Hantavirus infection in appropriate clinical scenario in India.

 


Keywords


Hantavirus infection, Renal insufficiency, Hypoalbuminemia, Thrombocytopenia

Full Text:

PDF

References


Lee HW, Lee PW, Johnson KM. Isolation of the etiologic agent of Korean hemorrhagic fever. J Infect Dis. 1978;137:298-308.

McCaughey C, Hart CA. Hantaviruses. J Med Microbiol. 2000;49:587-99.

Chandy S, Mitra S, Sathish N, Vijayakumar TS, Abraham OC, Jesudason MV et al. A pilot study for serological evidence of Hantavirus infection in human population in south India. Indian J Med Res. 2005;122:211-5.

Nichol ST, Spiropoulou CF, Morzunov S, Rollin PE, Ksiazek TG, Feldmann H, Sanchez A, Childs J, Zaki S, Peters CJ. Genetic identification of a Hanta virus associated with an outbreak of acute respiratory illness. Sci. 1993;262:914-7.

Kruger DH, Rainer U, Lundkvist A. Hantavirus infections and their prevention. Microbes Infect. 2001;3:1129-44.

Peters CJ. Infections caused by arthropod and rodent borne viruses. In: Longo DL, Kasper DL, Jameson JL, Faucy AS, Hauser SL, Loscalzo J, eds. Harrison’s Principles of Internal Medicine. 18th ed. New York: Mc Graw Hill; 2012: 1630-1631.

Peters CJ, Simpson GL, Levy H. Spectrum of Hantavirus infection: Hemorrhagic fever with renal syndrome and hantavirus pulmonary syndrome. Annu Rev Med. 1999;50:531-45.

Golovljova I, Vasilenko V, Mittzenkov V, Prukk T, Seppet E, Vene S et al. Characterization of hemorrhagic fever with renal syndrome caused by hantaviruses, Estonia. Emerg Infect Dis. 2007;13:1773-6.

Mehta S, Jiandani P. Ocular features of Hantavirus infection. Indian J Ophthalmol. 2007;55:378-80.

Nguyen AT, Penalba C, Bernadac P, Jaafar S, Kessler M, Canton P, Hoen B. Respiratory manifestations of hemorrhagic fever with renal syndrome. Retrospective study of 129 cases in Champagne-Ardenne and Lorraine. Presse Med. 2001;30:55-8.

Miyamoto H, Kariwa H, Araki K, Lokugamage K, Hayasaka D, Cui BZ et al. Serological analysis of hemorrhagic fever with renal syndrome (HFRS) patients in far Eastern Russia and identification of the causative hantavirus genotype. Arch Virol. 2003;148:1543-56.

Chandy S, Mitra S, Sathish N, Vijayakumar TS, Abraham OC, Jesudason MV et al. A pilot study for serological evidence of Hanta virus infection in human population in south India. Indian J Med Res. 2005;122:211-5.

Clement J, Maes P, Muthusethupathi M, Nainan G, van Ranst M. First evidence of fatal Hanta virus nephropathy in India, mimicking leptospirosis. Nephrol Dial Transplant. 2006;21:826-7.

Lázaro ME, Cantoni GE, Calanni LM, Resa AJ, Herrero ER, Iacono MA, Enria DA, González Cappa SM. Clusters of hantavirus infection, southern Argentina. Emerg Infect Dis. 2007;13:104-10.