Department of Nephrology, Klinikum Stuttgart, Kriegsbergstraße 60, 70174, Stuttgart, Germany.
Department of Internal Medicine, Division of Nephrology, Robert-Bosch-Hospital, Stuttgart, Germany.
Pediatr Nephrol. 2019 Jul;34(7):1247-1252. doi: 10.1007/s00467-019-04215-9. Epub 2019 Mar 14.
Hantavirus infections are endemic worldwide, and its incidence in Europe has been steadily increasing. In Western Europe, hantavirus infections are typically caused by Puumala hantavirus and cause nephropathia epidemica (NE), a mild form of haemorrhagic fever with renal syndrome. Up to now, there is only little data about the course of acute NE in children, but it has been suggested that hantavirus infections take a lighter course in children when compared to adults. We performed a retrospective analysis of adults and children diagnosed with acute NE in two counties in South-Western Germany to investigate if there are differences in the course of the disease.
We reviewed the medical records of 295 adults and 22 children with acute NE regarding clinical presentation, laboratory findings, complications and outcome.
Acute kidney injury (AKI) and thrombocytopenia occurred at similar frequencies and severity in both groups. Sudden onset of fever and back/loin pain were two of the three most common symptoms in both adults and children. However, adults presented more frequently with arthralgia and visual disturbances, whereas abdominal pain and nausea/vomiting could be detected more often in children. No significant differences were found in the incidence of complications (haemodialysis, long-term outcome of kidney function, length of hospital stay).
The clinical course of acute NE was similar in adults and children with high frequency of AKI as well as thrombocytopenia, but with full recovery of all patients.
汉坦病毒感染在全球范围内流行，其在欧洲的发病率呈稳步上升趋势。在西欧，汉坦病毒感染通常由普马拉病毒引起，导致肾综合征出血热（NE），这是一种轻度出血性肾综合征。到目前为止，关于儿童急性 NE 的病程仅有少量数据，但有研究表明，与成年人相比，儿童感染汉坦病毒的病程较轻。我们对德国西南部两个县诊断为急性 NE 的成人和儿童进行了回顾性分析，以调查疾病过程是否存在差异。
我们回顾了 295 例成人和 22 例儿童急性 NE 的病历，以了解临床表现、实验室发现、并发症和结局。
两组的急性肾损伤（AKI）和血小板减少症的发生率和严重程度相似。突然发热和腰背/腰部疼痛是两组中三个最常见症状中的两个。然而，成年人更常出现关节痛和视觉障碍，而腹痛和恶心/呕吐在儿童中更常见。并发症（血液透析、肾功能长期结局、住院时间）的发生率无显著差异。
急性 NE 的临床病程在成人和儿童中相似，AKI 和血小板减少症的发生率均较高，但所有患者均完全康复。
