1.Serum and urine soluble HLA class I antigen concentrations are increased in patients with hemorrhagic fever with renal syndrome.
Choel Whee PARK ; Sung No YUN ; Chul Woo YANG ; Tai Gyu KIM ; Hoon HAN ; Euy Jin CHOI ; Yoon Sik CHANG ; Byung Kee BANG
The Korean Journal of Internal Medicine 1997;12(1):52-57
OBJECTIVES: In order to evaluate the association between the Hantaan virus-induced cellular-immune response and clinical severity in patients with hemorrhagic fever with renal syndrome (HFRS). METHODS: We serially measured the serum (n = 16) and urine (n = 6) concentrations of soluble HLA class 1 antigen (sHLA-l) and clinical powameters in patients with HFRS. RESULTS: Serum sHLA-I concentrations in patients with HFRS were significantly higher than those in controls throughout all clinical phases (p < 0.01). The highly elevated Serum sHLA-I concentrations peaked in the oliguric phase and declined gradually through the phases of HFRS. Serum sHLA-l concentrations in patients with hypotensive episode were higher than in those without the episode (5,85 +/-2,184 vs. 2,389 +/- 860 ng/ml in oliguric phase, 4.11 +/- 1,952 vs. 1,502 +/- 592 ng/ml in diuretic phase, p < 0.05), and serum sHLA-l levels showed a significant correlation with blood WBC count (r = 0.75 in the febrile and hypotensive phase, p < 0.01) and serum creatinine concentrations (r = 0.64 in the oliguric phase, p< 0.01), respectively, Urine sHLA-I levels in the oliguric phase were significantly higher than those in the diuretic phase (390 +/- 155 vs. 214 +/- 45 ng/mg Cr, p < 0.05) and urine sHLA-I levels are associated with severe illness in patients with HFRS. The higher serum sHLA-I are associated with severe illness in patients with HFRS. The persistent elevation of serum sHLA-I during all phases of HFRS might be related to increased production due to prolonged cellular immunologic stimulation by the Hantaan virus rather than decreased excretion of sHLA-I through the kidney. CONCLUSION: We suggest that the serum and urine sHLA-I concentrations can be used as a stable and objective parameter for monitoring clinical severity and renal dysfunction in patients with HFRS.
Adult
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Enzyme-Linked Immunosorbent Assay
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HLA-A Antigens/urine*
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HLA-A Antigens/blood*
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Hemorrhagic Fever with Renal Syndrome/physiopathology
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Hemorrhagic Fever with Renal Syndrome/immunology*
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Human
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Male
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Sensitivity and Specificity
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Severity of Illness Index
2.Implication of liver function in hemorrhagic fever patients with renal syndrome.
Bao-mei WAN ; He-lou LI ; Jing WANG ; Hui-liang WANG ; Qiang GUO
Chinese Journal of Hepatology 2005;13(5):387-388
Adolescent
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Adult
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Aged
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Child
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Female
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Hemorrhagic Fever with Renal Syndrome
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physiopathology
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Humans
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Liver
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physiopathology
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Liver Function Tests
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Male
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Middle Aged
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Prognosis
3.A Case of Torsade de Pointes Associated with Hypopituitarism due to Hemorrhagic Fever with Renal Syndrome.
Nam Ho KIM ; Jeong Gwan CHO ; Young Keun AHN ; Seung Uk LEE ; Kun Hyung KIM ; Jang Hyun CHO ; Han Gyun KIM ; Wan KIM ; Myung Ho JEONG ; Jong Chun PARK ; Jung Chaee KANG
Journal of Korean Medical Science 2001;16(3):355-359
We describe a 51-yr-old man presenting with syncope due to torsade de pointes. The torsade de pointes was refractory to conventional medical therapy, including infusion of isoproterenol, MgSO4, potassium, lidocaine, and amiodarone. His past history, physical findings, and hormone study confirmed that QT prolongation was caused by anterior hypopituitarism that developed as a sequela of hemorrhagic fever with renal syndrome. The long QT interval with deep inverted T wave was completely normalized 4 weeks after starting steroid and thyroid hormone replacement. Hormonal disorders should be considered as a cause of torsade de pointes, because this life-threatening arrhythmia can be treated by replacing the missing hormone.
Hemorrhagic Fever with Renal Syndrome/*complications/physiopathology
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Hormone Replacement Therapy
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Human
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Hypopituitarism/drug therapy/*etiology/physiopathology
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Male
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Middle Age
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Tachycardia, Ventricular
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Torsades de Pointes/drug therapy/*etiology/physiopathology
4.Clinical characteristics of patients with hemorrhagic fever with renal syndrome.
Hong ZHAO ; Yong-qing DOU ; Yan WANG ; Jun LI ; Gui-qiang WANG
Chinese Journal of Experimental and Clinical Virology 2008;22(1):12-14
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