Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland.
Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland.
Viruses. 2021 Sep 13;13(9):1818. doi: 10.3390/v13091818.
Central and peripheral hormone deficiencies have been documented during and after acute hantavirus infection. Thrombocytopenia and coagulation abnormalities are common findings in haemorrhagic fever with renal syndrome (HFRS). The associations between coagulation and hormonal abnormalities in HFRS have not been studied yet. Forty-two patients diagnosed with Puumala virus (PUUV) infection were examined during the acute phase and on a follow-up visit approximately one month later. Hormonal defects were common during acute PUUV infection. Overt (clinical) hypogonadism was identified in 80% of the men and approximately 20% of the patients had overt hypothyroidism. At the one-month follow-up visit, six patients had central hormone deficits. Acute peripheral hormone deficits associated with a more severe acute kidney injury (AKI), longer hospital stay and more severe thrombocytopenia. Half of the patients with bleeding symptoms had also peripheral hormonal deficiencies. Patients with free thyroxine levels below the reference range had higher D-dimer level than patients with normal thyroid function, but no thromboembolic events occurred. Acute phase hormonal abnormalities associate with severe disease and altered haemostasis in PUUV infection.
在汉坦病毒感染期间和之后，已经记录到中枢和外周激素缺乏。血小板减少和凝血异常是肾综合征出血热（HFRS）的常见表现。HFRS 中凝血和激素异常之间的关联尚未得到研究。在急性阶段和大约一个月后的随访中，对 42 名诊断为普马拉病毒（PUUV）感染的患者进行了检查。在急性 PUUV 感染期间，激素缺陷很常见。80%的男性和大约 20%的患者出现显性性腺功能减退，显性甲状腺功能减退。在一个月的随访中，6 名患者出现中枢激素缺乏。急性外周激素缺乏与更严重的急性肾损伤（AKI）、更长的住院时间和更严重的血小板减少症相关。一半有出血症状的患者也有外周激素缺乏。游离甲状腺素水平低于参考范围的患者 D-二聚体水平高于甲状腺功能正常的患者，但没有发生血栓栓塞事件。急性阶段的激素异常与 PUUV 感染中的严重疾病和凝血改变相关。
