Korean Hemorrhagic Fever was recognized during the Korean War (1950-1953) and intensive studies have been done especially in early 1950's. However, the etiologic agent, vector, and reservoir are not known conclusively. The occurrence has two peak seasons in spring and autumn, and is not limited to military personnel in front lines but also civilians are attacked. Still the study is going on.
Diagnosis, Differential ; Hemorrhagic Fever with Renal Syndrome/epidemiology* ; Hemorrhagic Fever with Renal Syndrome/pathology ; Hemorrhagic Fever with Renal Syndrome/transmission ; Human ; Korea

It has been reported in autopsy that most of the patients with Korean hemorrhagic fever had necrotic areas inthe anterior lobe of the pituitary gland. The high resolution CT of sella was performed to demonstrate thepossible pituitary necrosis in consecutive 13 patients with Korean hemorrhagic fever. Only 3 patients demonstrate normal sellar findings. Ten (77%) out of 13 cases reveal abnormal findings; 2 patients show typical empty sellar and the rest (8 patients) reveal localized low denstiy area in the anterior portion of the sella turcica, which may be from partial empty sella, pituitary infarction or other unknown pathology. The low denisties within the sella will be discussed.
Autopsy ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Infarction ; Necrosis ; Pathology ; Pituitary Gland ; Sella Turcica

The purpose of this study is to delineate the histopathologic findings of the spleen after Hantaan viral inoculation, which is the largest lymphoid organ in rats, and to identify the viral location by anti-Hantaan virus (HTNV) monoclonal antibody. All the sixty one suckling rats of less than twenty four hours of age were used. Except twenty one rats of control group, twenty-five rats inoculated intracerebrally for the early change and fifteen suckling rats inoculated intramuscularly for the late change were uniformly susceptible to lethal infection with the ROK 84-105-1 strain of seed HTNV. The characteristic histopathologic findings were; appearance of macrophages below the splenic capsule on the 3rd day, small lymphocytes around the periarteriolar sheath on the 5th day increasing in numbers on the 7th day, and a markedly expanded marginal zone with some immunoblasts and plasma cells as well as decreased extramedullary hematopoiesis on the 9th and 14th days. Time of onset of histopathologic changes in spleen thickness, appearance of medium and large lymphocytes and degree of extramedullary hematopoiesis were influenced by inoculation route, whereas expansion of the marginal zone was affected by postnatal age.
Animals ; Animals, Suckling ; Antigens, Viral/analysis ; Hantavirus/immunology ; Hematopoiesis ; Hemorrhagic Fever with Renal Syndrome/*pathology ; Rats ; Rats, Inbred Strains ; Spleen/*pathology

Light and electron microscopic studies of megakaryocytes in bone marrow from 14 cases of Korean epidemic hemorrhagic fever were made, together with clinical manifestations, laboratory findings, and changes in other marrow elements. The number of megakaryocytes increased in various degree from patient to patient, with a shift to the left of maturation gradation. Cytoplasms were markedly smaller but granularity was fairly good. The most constant finding was marked decrease or complete absence of platelet formation at the periphery of the cytoplasm. Ultrastructurally, there was a marked decrease of the cisternal system in the cytoplasm and lack of cleavage line. No virus particles or active degenerative process was noted. These changes of the megakaryocytes are similar to those reported in idiopathic thrombocytopenic purpura, indicating that megakaryocytic changes in Korean epidemic hemorrhagic fever are likely secondary to thrombocytopenia which was caused by other Mechanism.
Adult ; Aged ; Bone Marrow/pathology ; Female ; Hemorrhagic Fever with Renal Syndrome/pathology* ; Human ; Male ; Megakaryocytes/ultrastructure* ; Middle Age

Adolescent ; Child ; Child, Preschool ; Electrocardiography ; Female ; Fever ; complications ; Hemorrhagic Fever with Renal Syndrome ; blood ; complications ; pathology ; Humans ; Hypergammaglobulinemia ; blood ; Immunoglobulin M ; blood ; Male ; Pain ; complications

This is the first case of virus-associated encephalitis/encephalopathy in which the pathogen was Hantaan virus. A 53-yr-old man presented fever, renal failure and a hemorrhagic tendency and he was diagnosed with hemorrhagic fever with renal failure syndrome (HFRS). In the course of his illness, mild neurologic symptoms such as dizziness and confusion developed and magnetic resonance images revealed a reversible lesion in the splenium of the corpus callosum. This case suggests that HFRS patients with neurologic symptoms like dizziness and mental slowing should be considered to have structural brain lesions and to require brain imaging studies.
Antibodies, Viral/blood ; Corpus Callosum/*pathology ; Diagnosis, Differential ; Hantaan virus/immunology ; Hemorrhagic Fever with Renal Syndrome/*diagnosis/therapy ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Platelet Count ; Renal Dialysis

OBJECTIVEPatients with typical clinical manifestations of Hemorrhagic fever with renal syndrome (HFRS) are becoming fewer. We conducted analysis on clinical features of HFRS in order to reduce the mistakes in diagnosis.

METHODS64 patients were diagnosed as HFRS during May, 2000 to June, 2006 in our hospital. All the patients' serological tests (HFRS-NP-specific IgM, IgG antibody) by ELISA method were positive. We collected their clinical manifestations and test results. SPSS 12.0 was used in our statistical analysis.

RESULTSAmong the 64 patients, 71.6% of all the cases occurred from Feb. to June. Most of patients were admitted to the hospital with untypical manifestation. Only 30.6% patients appeared headache, lumbago, and pain of orbital cavity. 32.8% patients had obviously signs of injection and hemorrhage. However, there were 90.6% patients with headache and 84.4% patients with nausea or vomit. Hypotensive or oliguric phases were absent in 56.3% patients. There were only 31.3% patients with all five stages. Thrombocytopenia (79.7%) and heavy proteinuria (71.9%) were common. But 54.7% of patients shown normal or even decreased white blood cell count. Only 2/3 of patients had elevated serum creatinine (Cr). Liver involved was common showing as elevated aminotransferase. ALT level was not always parallel to Cr level. There was an opposite trend between them.

CONCLUSIONWe must recognized the untypical manifestations of HFRS. Further study focus on pathogenesis was useful for diagnosis and therapy.

Adolescent ; Adult ; Aged ; Alanine Transaminase ; blood ; Creatinine ; blood ; Female ; Hemorrhagic Fever with Renal Syndrome ; blood ; pathology ; physiopathology ; Humans ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; Male ; Middle Aged

HSP70 Heat-Shock Proteins ; analysis ; Hemorrhagic Fever with Renal Syndrome ; metabolism ; pathology ; Hepatitis Antigens ; analysis ; Hepatitis, Viral, Human ; immunology ; pathology ; Humans ; SARS Virus ; isolation & purification ; Severe Acute Respiratory Syndrome ; pathology ; virology

BACKGROUNDTo observe cytopathogenic effect of Hantaan virus (HV) on cultured human bone marrow cells.

METHODSLight and transmission electron microscopy and direct immunofluorescent technique were applied to study cellular structure especially ultrastructural changes of bone marrow cells from patients with Hantaan virus infection. Bone marrow cells of one healthy volunteer were also studied as control.

RESULTSThe antigen of HV was found in bone marrow cells of 20 of 27 HFRS patients by the aid of direct immunofluorescent technique. It was found that the granulocytes had the highest percentage of HV antigen positive cells (76%), followed by monocytes (65%), lymphocytes (40%), megakaryocytes (20%) and the lowest was found in erythrocytes (3.7%). The injury of cell membrane after infection with HV was significantly more severe than that in the control group under the light and electron microscopy.

CONCLUSIONThis study demonstrated that HV could attack human bone marrow cells and cause cytopathogenic effect on them.

Adult ; Aged ; Antigens, Viral ; analysis ; Bone Marrow Cells ; ultrastructure ; virology ; Female ; Fluorescent Antibody Technique, Direct ; Hantavirus ; immunology ; pathogenicity ; Hemorrhagic Fever with Renal Syndrome ; pathology ; virology ; Humans ; Male ; Microscopy, Electron, Scanning ; Microscopy, Fluorescence ; Middle Aged