Volume 10, Number 8—August 2004
Research
Thrombocytopenia and Acute Renal Failure in Puumala Hantavirus Infections
Franz Maximilian Rasche*
, Boris Uhel*, Rainer Ulrich†, Detlev H. Krüger†, Wolfram Karges*, David Czock*, Walter Hampl*, Frieder Keller*, Helga Meisel†, and Lutz von Müller*
, Boris Uhel*, Rainer Ulrich†, Detlev H. Krüger†, Wolfram Karges*, David Czock*, Walter Hampl*, Frieder Keller*, Helga Meisel†, and Lutz von Müller*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.
