Volume 24, Number 6—June 2018
CME ACTIVITY - Research
Bioclinical Test to Predict Nephropathia Epidemica Severity at Hospital Admission
Maxime Hentzien
, Stéphanie Mestrallet, Pascale Halin, Laure-Anne Pannet, Delphine Lebrun, Moustapha Dramé, Firouzé Bani-Sadr, Jean-Marc Galempoix, Christophe Strady, Jean-Marc Reynes, Christian Penalba, and Amélie Servettaz
, Stéphanie Mestrallet, Pascale Halin, Laure-Anne Pannet, Delphine Lebrun, Moustapha Dramé, Firouzé Bani-Sadr, Jean-Marc Galempoix, Christophe Strady, Jean-Marc Reynes, Christian Penalba, and Amélie Servettaz
Table 1
Clinical characteristics of 205 hospitalized patients with nephropathia epidemica, Ardennes Department, France, January 2000–December 2014*
| Characteristic | Value | Missing |
|---|---|---|
| Sex | ||
| M | 153 (74.6) | 0 |
| F |
52 (25.4) |
0 |
| Age, y, mean ± SD |
38.6 ± 14.3 |
0 |
| Charlson comorbidity index score, median (IQR) | 0 (0–0) | 0 |
| >0 |
24 (11.7) |
|
| Chronic renal disease | 4 (2.0) | 0 |
| Time from onset of symptoms to hospitalization, d, mean ± SD |
5.3 ± 2.7 |
0 |
| Nephrotoxic drug intake† | 60 (29.3) | 0 |
| Nonsteroidal anti-inflammatory drugs | 35 (17.1) | 0 |
| Iodinated contrast media | 9 (4.4) | 0 |
| Diuretics | 14 (6.8) | 0 |
| Renin angiotensin aldosterone system inhibitors | 12 (5.9) | 0 |
| Nephrotoxic antimicrobial drugs |
5 (2.4) |
0 |
| Clinical signs and symptoms at admission | ||
| Fever | 203 (99.5) | 1 |
| Arthromyalgia | 167 (81.5) | 0 |
| Low back pain | 92 (44.9) | 0 |
| Visual disorders | 68 (33.2) | 0 |
| Chest symptoms | 96 (46.8) | 0 |
| Cough | 65 (31.7) | 0 |
| Dyspnea | 11 (5.4) | 0 |
| Chest auscultation abnormalities | 34 (16.6) | 0 |
| Pathological chest radiograph | 41 (23.0) | 27 |
| Digestive symptoms | 144 (70.2) | 0 |
| Nausea | 107 (52.2) | 0 |
| Diarrhea | 38 (18.5) | 0 |
| Abdominal pain | 104 (50.7) | 0 |
| Oliguria during clinical course | 32 (15.6) | 0 |
| Neurologic signs | 149 (72.7) | 0 |
| Meningism | 21 (10.2) | 0 |
| Headache without meningism | 147 (71.7) | 0 |
| Nonsevere hemorrhagic signs‡ |
28 (13.7) |
0 |
| Laboratory findings at admission | ||
| Hemoglobin, g/L, mean ± SD | 146 ± 15 | 10 |
| Platelet count, × 109/L, median (IQR) | 92 (66–123) | 1 |
| >90 | 104 (50.9) | |
| 50–<90 | 78 (38.2) | |
| <50 | 22 (10.8) | |
| Leukocyte count, × 109 cells/L, mean ± SD | 8.0 ± 3.2 | 5 |
| >10 | 45 (22.5) | 5 |
| Neutrophil count, × 109 cells/L, mean ± SD | 5.5 ± 2.4 | 7 |
| Lymphocyte count, × 109 cells/L, mean ± SD | 1.3 ± 0.7 | 11 |
| <1 | 78 (40.2) | 11 |
| Creatinine, µmol/L, median (IQR) | 98 (79–130) | 6 |
| Alanine aminotransferase, × ULN, median (IQR) | 1.0 (1.0–1.5) | 28 |
| Aspartate aminotransferase, × ULN, median (IQR) | 1.0 (1.0–1.5) | 26 |
| C-reactive protein, median (IQR) | 79 (46–117) | 2 |
| >100 mg/L, >952 nmol/L | 70 (34.5) | 2 |
| Hematuria | 6 | |
| Absent | 103 (51.8) | |
| Microscopic | 90 (45.2) | |
| Macroscopic | 6 (3.0) | |
| Urine dipstick proteinuria§ | 128 | |
| 0 | 15 (17.9) | |
| + | 15 (17.9) | |
| ++ | 15 (17.9) | |
| +++ | 20 (23.8) | |
| ++++ | 12 (14.3) |
*Vales are n (%) unless otherwise specified. IQR, interquartile range; ULN, upper limit of normal.
†More than 1 factor is possible.
‡Defined as hemorrhagic signs not requiring blood transfusion.
§For urine dipstick readings, 0 indicates no proteinuria, + indicates ≈30 mg/dL, ++ indicates ≈100 mg/dL, +++ indicates ≈300 mg/dL, and ++++ indicates ≈2,000 mg/dL.
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Page updated: May 15, 2018
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