Abstract
From January 1988 to September 1989, seven patients (4 girls and 3 boys, aged 3–12 years) with haemorrhagic fever with renal syndrome (HFRS) were hospitalised at the University Children's Hospital in Belgrade. In four patients the disease appeared as a family outbreak, the others were sporadic cases. In six patients the clinical presentation was suggestive of HFRS, as they had fever with headache, myalgia, sore throat and gastrointestinal illness followed by renal abnormalities. However, severe haemorrhagic syndrome with petechia, haematoma, haematemesis and melaena was present in one patient only. Renal disease presented as nephritic syndrome and/or acute renal failure. Five patients recovered after 2–3 weeks without sequellae, one patient had decreased renal function 17 months after the start of the disease and the remaining patient died. In six patients the diagnosis of HFRS was confirmed serologically by a significant rise in antibody titres against hantaviruses, while in the patient with the fatal and fulminant course of the disease, the diagnosis was established on the basis of epidemiological and autopsy findings. We suggest that children living in endemic areas who develop an ill-defined, febrile and gastrointestinal disease with renal dysfunction should be evaluated for HFRS.
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References
Antonijevié B (1984) Istrazivanje etiologije kliničkih manifestacija i epidemiologije hemoragičnih groznica sa bubrznim sindromom (HFRS) i njihova uzajamna povezanost sa etiologijom prirodnih zarista. Thesis, University of Belgrade, Yugoslavia
Suša S (1979) Virusne hemoragijske groznice i bubreg. Savremena administracija, Belgrade, pp 60–72
Lee HW, Lee PW, Johnson KM (1978) Isolation of the etiological agent of Korean hemorrhagic fever. J Infect Dis 137:298–308
LeDuc JW (1987) Epidemiology of Hantaan and related viruses. Lab Anim Sci 37:413–418
Melin JP, Toupance O, Lavaoud S, Brunois JP, Dropsy G, Rollin P, Sureau P, Chanard J (1984) Fièvre hémorragique avec syndrome rénale due au virus Hantaan ou á un virus sérologiquement apparanté. Presse Med 13:2741–2745
Antoniadis A, Pyrpasopoulos M, Sion M, Daniel S, Peters CJ (1984) Two cases of hemorrhagic fever with renal syndrome in Northern Greece. J Infect Dis 149:1011–1013
Salvadori M, Lombardi M, Bandini S, Leoncini F, Bartolozzi D, Balducci M, Verani P, Nicoletti L (1989) Acute renal involvement in Hantaan virus infection: first report in Italy. J Nephrol 1:17–22
Gonzalez JP, McCormick JB, Baudon D, Gautun JP, Meunier DY, Dournon E, Georges AJ (1984) Serological evidence for Hantaan-related virus in Africa. Lancet II:1036–1037
Walker E, Pinkerton IW (1984) Scottish case of haemorrhagic fever with renal syndrome. Lancet, II:982
Lee HW, Seong IW, Baek LJ, McLeod DA, Seo TS, Kang CY (1984) Positive serological evidence that Hantaan virus, the etiological agent of hemorrhagic fever with renal syndrome, is endemic in Canada. Can J Microbiol 30:1137–1140
Rollin PE, Nawrocka E, Rodhain F, Sureau P, McCormick JB (1986) Serological data on hemorrhagic fever with renal syndrome in Southeast Asia. Bull Soc Pathol Exot Filiales 79:473–475
Gartner L, Emmerich P, Schmitz H (1988) Hantaan virus infection as a cause of acute kidney failure. 3 cases in West Germany. Dtsch Med Wochenschr 113:937–940
WHO Expert Committee Report (1989) WHO, Seoul
Gligić A, Stojanović R, Obradović M, Hlaca D, Dimković D, Diglišić G, Lukać V, Ler Z, Boganović R, Antonijević B, Ropac D, AvsićT, LeDuc JW, Ksiazek T, Yanagagihara R, Gajdusek DC, Hemorrhagic fever with renal syndrome in Yugoslavia: epidemiologic and epizootiologic features of a nation-wide outbreak in 1989. Eur J Epidemiol (in press)
Lee PW, Gibbs CJ, Gajdušek DC, Yanagihova R (1985) Serotypic classification of Hantaviruses by indirect immunofluorescent antibody and plaque reduction neutralization tests. J Clin Microbiol 22: 940–944
Antić D, Byung-UKL, Yong Kang C (1991) Molecular characterization of the M genomic segment of the Seoul 80-39 virus; nucleotide and amino acid sequence comparisons with other hantaviruses reveal the evolutionary pathway. Virus Res 19:47–58
Simić M, Mirić V (1952) Success of application of peritoneal dialysis in one case of renal insufficiency. Vojnosanit Pregl 9:285–290
Gaon J, Karlovac M, Gresikova M, Hlaca D, Rukavina J, Knezović J, Saratlić-Savić D, Vampotić A (1968) Epidemiological features of hemorrhagic fever. Folia Med Facult Med Univers Saraevien 3: 23–41
Vesenjak-Hirjan J, Hrabar A, Vince-Ribarić V, Borčić B, Brudnjak Z (1971) An outbreak of hemorrhagic fever with renal syndrome in the Plitvica Lakes area. Folia Parasitol (Praha) 18:275–279
Gligić A, Obradović M, Stojanović R, Ovčarić A, Vujoćević N, Tmušić K, Nastić D (1988) Hemorrhagic fever with renal syndrome in Yugoslavia. Acta Med Sal 17:141–145
Gligić A, Frušić M, Obradović M, Stojanović R, Hlača D, Gibbs JC, Yanagihova R, Calisher CH, Gajdušek DC (1989) Hemorrhagic fever with renal syndrome in Yugoslavia: antigenic characterization of hantaviruses isolated fromApodemus flavicolis andClethrionomys glariolus. Am J Trop Med Hyg 41:109–115
Gligić A, Obradović M, Stojanović R, Vujošević N, Ovčarić A, Frušić M, Gibbs JC, Calisher CH, Gajdušek DC (1989) Epidemic hemorrhagic fever with renal syndrome in Yugoslavia 1986. Am J Trop Med Hyg 41:102–108
Antoniades A, Grekas D, Rpssi CA, LeDuc JW (1987) Isolation of a hantavirus from a severely ill patient with hemorrhagic fever with renal syndrome in Greece. J Infect Dis 156:1010–1013
Macanović M, Golemac S, Verbić D, Karamehić J (1986) Acute tubular necrosis in patients with haemorrhagic fever. Proceedings of the 3rd Congress of Yugoslav Nephrologists, Ljubljana, December 4–6, 1985, p 118–119
Suša S, Dumković B, Pantović R, Škatarić V (1986) Acute renal failure in hemorrhagic fever with renal syndrome. Proceedings of the 3rd Congress of Yugoslav Nephrologists, Ljubljana, December 4–6, 1985, p 66–69
Grcevska L, Polenaković M, Ončevski A, Zografski DJ, Gligić A (1990) Different pathohistological presentations of acute renal involvement in Hantaan virus infection: report of two cases. Clin Nephrol 34:197–201
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Peco-Antić, A., Popović-Rolović, M., Gligić, A. et al. Clinical characteristics of haemorrhagic fever with renal syndrome in children. Pediatr Nephrol 6, 335–338 (1992). https://doi.org/10.1007/BF00869727
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DOI: https://doi.org/10.1007/BF00869727