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Volume 10, Number 8—August 2004

Research

Thrombocytopenia and Acute Renal Failure in Puumala Hantavirus Infections

Franz Maximilian Rasche*Comments to Author , Boris Uhel*, Rainer Ulrich†, Detlev H. Krüger†, Wolfram Karges*, David Czock*, Walter Hampl*, Frieder Keller*, Helga Meisel†, and Lutz von Müller*
Author affiliations: *University Hospital Ulm, Ulm, Germany; †Charité, Berlin, Germany

Main Article

Table 1

Characteristics of 15 patients with acute PUUV infection associated with mild or severe acute renal failurea,b

Mild acute renal failure
(n = 8) Severe acute renal failure
(n = 7) p value
Age (y)
38 (25–53)
35 (22–53)
n.s.c,d
Sex (male:female ratio)
5:3
7:0
n.s.e
Fever (>38.5°C)
8
7
n.s.e
Abdominal or loin pain
7
5
n.s.e
Fatigue
4
6
n.s.e
Myalgia
5
4
n.s.e
Hepatitis (ALT >20 U/mL)
4
5
n.s.e
Headache
4
3
n.s.e
Nausea/vomiting
1
5
0.041e
Conjunctival bleeding
1
2
n.s.e
Purpura
0
2
n.s.e
Highest C-reactive protein (mg/L)
50 (27–112)
90 (7–122)
n.s.d
Lowest platelet count (x 109/L)b
113 (26–250)
34 (18–122)
0.016d
Highest leukocyte count (x 109/L)
9.9 (8.0–15.3)
15.1 (12.0–22.7)
0.029d
Lowest serum calcium (mmol/L)
2.22 (1.85–2.27)
2.02 (1.98–2.21)
0.029d
Hematuria (cells/min)
10.2 (2.6–27)
76.4 (21.2–129.0)
0.009d
Leukocyturia (cells/min)
16.2 (10.4–22)
41.0 (17.5–191.0)
0.0017d
Proteinuria (>1.5 g/day)
2
4
n.s.e
Tubular cell casts 1 5 0.001e

aPUUV, Puumala virus; mild and severe acute renal failure was defined as serum creatinine <620 μmol/L and >620 μmol/L, respectively; ALT, alanine aminotransferase.
bOf all parameters, only thrombocytopenia predicted subsequent severe renal failure. Medians (range) and actual number of patients are given.
cn.s., not significant.
dMann-Whitney U test.
eFisher exact test.

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