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Hantavirüse Bağlı Renal Sendromlu Hemorajik Ateş Sonrası Panhipopitüitarizm

Year 2015, Volume: 6 Issue: 2, 23 - 25, 01.04.2015

Abstract

Giriş: Renal Sendromlu Hemorajik Ateş (RSHA), Hantavirüs cinsine
bağlı virüslerce oluşan akut bir viral hastalıktır. Hantavirüsler; ateş,
dolaşım bozukluğu, kanama ve renal yetmezlik ile karekterize bir
hastalık spektrumuna neden olurlar. Hipopitütiarizmin bilinen
nedenleri pitüiter iskemi/infarkt ve nekroz olup klinik özelliklerinin
belirsiz olmasından dolayı genellikle farkedilemezler. Bu yazıda,
acil servise (AS) açıklanamayan hipoglisemi nedeni ile sevkedilen
RSHA sonrası panhipopitüitarizm gelişen 60 yaşına erkek
olgusunu sunduk.
Olgu Sunumu: Biz acil servise RSHA sonrası gelişen
panhipopitutuarizm beraber AS’ye açıklanamayan hipoglisemi
ile başvuran 60 yaşında bir erkek hasta sunduk. Hastanın kan
tetkiklerinde panhipopituitarizm ve anti-Hantavirüs IgG ve IgM
pozitifliği tespit edildi. Hormon replasman tedavisi başlandı ve
hasta ayaktan takibe alınarak tam iyileşme ile taburcu edildi.
Sonuç: Panhipopituitarizm RSHA sonrası çok nadir görülen bir
komplikasyondur. Morbidite ve mortaliteyi azaltmak için; acil tıp,
dahili tıp ve enfeksiyon hastalıkları uzmanları bu komplikasyona
karşı uyanık olmalıdırlar

References

  • Schmaljohn CS, Hasty SE, Dalrymple JM, LeDuc JW, Lee HW, von Bonsdorff CH, et al. Antigenic and genetic properties of viruses linked to hemorrhagic fever with renal syndrome. Science 1985; 227: 1041-4. [CrossRef]
  • Vapalahti O, Mustonen J, Lundkvist A, Henttonen H, Plyusnin A, Vaheri A. Hantavirus infections in Europe. Lancet Infect Dis 2003; 3: 653-61. [CrossRef]
  • Bi Z, Formenty PB, Roth CE. Hantavirus infection: a review and global update. J Infect Dev Ctries 2008; 2: 3-23. [CrossRef]
  • Pekic S, Cvijanovic G, Stonjanovic M, Kendereski A, Micic D, Popovic V. Hypopituitarism as a late complication of hemorrhagic fever. Endocrine 2005; 26: 79-82. [CrossRef]
  • Suh DC, Park JS, Park SK, Lee HK, Chang KH. Pituitary hemorrhage as a complication of hantaviral disease. AJNR Am J Neuroradiol 1995; 16: 175-8.
  • Settergren B, Boman J, Linderholm M, Wiström J, Hägg E, Arvidsson PA. A case of nephropathia epidemica associated with panhypopituitarism and nephrotic syndrome. Nephron 1992; 61: 234-5. [CrossRef]
  • Hautala T, Sironen T, Vapalahti O, Pääkkö E, Särkioja T, Salmela PI, et al. Hypophyseal hemorrhage and panhypopituitarism during Puumala Virus Infection: Magnetic Resonance Imaging and detection of viral antigen in the hypophysis. Clin Infect Dis 2002; 35: 96-101. [CrossRef]
  • Stojanovic M, Pekic S, Cvijovic G, Miljic D, Doknic M, Nikolic-Djurovic M, et al. High risk of hypopituitarism in patients who recovered from hemorrhagic fever with renal syndrome. J Clin Endocrinol Metab 2008; 93: 2722-8. [CrossRef]
  • Jovanović D, Kovacević Z, Dragović T, Petrović M, Tadić J. Anterior pituitary lobe atrophy as late complication of hemorrhagic fever with renal syndrome. Vojnosanit Pregl 2009; 66: 166-8. [CrossRef]
  • Ertek M, Buzgan T; Refik Saydam National Public Health Agency; Ministry of Health, Ankara, Turkey. An outbreak caused by hantavirus in the Black Sea region of Turkey, January-May 2009. Euro Surveill 2009; 14. pii: 19214.
  • Sarıgüzel N, Hofmann J, Canpolat AT, Türk A, Ettinger J, Atmaca D, et al. Emerg Infect Dis Dobrava hantavirus infection complicated by panhypopituitarism, Istanbul, Turkey, 2010. 2012; 18: 1180-3.

Panhypopituitarism Following Hemorrhagic Fever with Renal Syndrome Due to Hantavirus

Year 2015, Volume: 6 Issue: 2, 23 - 25, 01.04.2015

Abstract

Introduction: Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease caused by viruses that belong to the genus Hantavirus. Hantaviruses produce a spectrum of illness characterized by fever, circulatory collapse, hemorrhages, and renal failure. Pituitary ischemia/infarction and necrosis are known causes of hypopituitarism, often remaining unrecognized because of subtle clinical manifestations. In this report, we present a case of a 60-year-old male patient who was referred to the emergency department (ED) for unexplained hypoglicemia, with panhypopituitarism following HFRS.Case Report: We, hereby, present a 60-year-old male patient admitted to the ED because of unexplained hypoglicemia, with panhypopituitarism following HFRS. Blood tests revealed panhypopituitarism and anti-hantavirus IgM and IgG positivity. Hormone replacement theraphy was initiated, and he was discharged for outpatient follow-up with total recovery.Conclusion: Panypopituitarism is an extremely rare complication of HFRS. Emergency medicine, internal medicine, and infectious diseases specialists should be aware of this complication to reduce mortality and morbidity

References

  • Schmaljohn CS, Hasty SE, Dalrymple JM, LeDuc JW, Lee HW, von Bonsdorff CH, et al. Antigenic and genetic properties of viruses linked to hemorrhagic fever with renal syndrome. Science 1985; 227: 1041-4. [CrossRef]
  • Vapalahti O, Mustonen J, Lundkvist A, Henttonen H, Plyusnin A, Vaheri A. Hantavirus infections in Europe. Lancet Infect Dis 2003; 3: 653-61. [CrossRef]
  • Bi Z, Formenty PB, Roth CE. Hantavirus infection: a review and global update. J Infect Dev Ctries 2008; 2: 3-23. [CrossRef]
  • Pekic S, Cvijanovic G, Stonjanovic M, Kendereski A, Micic D, Popovic V. Hypopituitarism as a late complication of hemorrhagic fever. Endocrine 2005; 26: 79-82. [CrossRef]
  • Suh DC, Park JS, Park SK, Lee HK, Chang KH. Pituitary hemorrhage as a complication of hantaviral disease. AJNR Am J Neuroradiol 1995; 16: 175-8.
  • Settergren B, Boman J, Linderholm M, Wiström J, Hägg E, Arvidsson PA. A case of nephropathia epidemica associated with panhypopituitarism and nephrotic syndrome. Nephron 1992; 61: 234-5. [CrossRef]
  • Hautala T, Sironen T, Vapalahti O, Pääkkö E, Särkioja T, Salmela PI, et al. Hypophyseal hemorrhage and panhypopituitarism during Puumala Virus Infection: Magnetic Resonance Imaging and detection of viral antigen in the hypophysis. Clin Infect Dis 2002; 35: 96-101. [CrossRef]
  • Stojanovic M, Pekic S, Cvijovic G, Miljic D, Doknic M, Nikolic-Djurovic M, et al. High risk of hypopituitarism in patients who recovered from hemorrhagic fever with renal syndrome. J Clin Endocrinol Metab 2008; 93: 2722-8. [CrossRef]
  • Jovanović D, Kovacević Z, Dragović T, Petrović M, Tadić J. Anterior pituitary lobe atrophy as late complication of hemorrhagic fever with renal syndrome. Vojnosanit Pregl 2009; 66: 166-8. [CrossRef]
  • Ertek M, Buzgan T; Refik Saydam National Public Health Agency; Ministry of Health, Ankara, Turkey. An outbreak caused by hantavirus in the Black Sea region of Turkey, January-May 2009. Euro Surveill 2009; 14. pii: 19214.
  • Sarıgüzel N, Hofmann J, Canpolat AT, Türk A, Ettinger J, Atmaca D, et al. Emerg Infect Dis Dobrava hantavirus infection complicated by panhypopituitarism, Istanbul, Turkey, 2010. 2012; 18: 1180-3.
There are 11 citations in total.

Details

Other ID JA45VA22GC
Journal Section Case Report
Authors

Abdülcelil Kayabaş This is me

Ali Oğuz Akgün This is me

Aynur Atilla This is me

Murat Güzel

Ali Kemal Erenler This is me

Gül Kefeli Gürses This is me

Publication Date April 1, 2015
Submission Date April 1, 2015
Published in Issue Year 2015 Volume: 6 Issue: 2

Cite

APA Kayabaş, A., Akgün, A. O., Atilla, A., Güzel, M., et al. (2015). Panhypopituitarism Following Hemorrhagic Fever with Renal Syndrome Due to Hantavirus. Journal of Emergency Medicine Case Reports, 6(2), 23-25.
AMA Kayabaş A, Akgün AO, Atilla A, Güzel M, Erenler AK, Kefeli Gürses G. Panhypopituitarism Following Hemorrhagic Fever with Renal Syndrome Due to Hantavirus. Journal of Emergency Medicine Case Reports. April 2015;6(2):23-25.
Chicago Kayabaş, Abdülcelil, Ali Oğuz Akgün, Aynur Atilla, Murat Güzel, Ali Kemal Erenler, and Gül Kefeli Gürses. “Panhypopituitarism Following Hemorrhagic Fever With Renal Syndrome Due to Hantavirus”. Journal of Emergency Medicine Case Reports 6, no. 2 (April 2015): 23-25.
EndNote Kayabaş A, Akgün AO, Atilla A, Güzel M, Erenler AK, Kefeli Gürses G (April 1, 2015) Panhypopituitarism Following Hemorrhagic Fever with Renal Syndrome Due to Hantavirus. Journal of Emergency Medicine Case Reports 6 2 23–25.
IEEE A. Kayabaş, A. O. Akgün, A. Atilla, M. Güzel, A. K. Erenler, and G. Kefeli Gürses, “Panhypopituitarism Following Hemorrhagic Fever with Renal Syndrome Due to Hantavirus”, Journal of Emergency Medicine Case Reports, vol. 6, no. 2, pp. 23–25, 2015.
ISNAD Kayabaş, Abdülcelil et al. “Panhypopituitarism Following Hemorrhagic Fever With Renal Syndrome Due to Hantavirus”. Journal of Emergency Medicine Case Reports 6/2 (April 2015), 23-25.
JAMA Kayabaş A, Akgün AO, Atilla A, Güzel M, Erenler AK, Kefeli Gürses G. Panhypopituitarism Following Hemorrhagic Fever with Renal Syndrome Due to Hantavirus. Journal of Emergency Medicine Case Reports. 2015;6:23–25.
MLA Kayabaş, Abdülcelil et al. “Panhypopituitarism Following Hemorrhagic Fever With Renal Syndrome Due to Hantavirus”. Journal of Emergency Medicine Case Reports, vol. 6, no. 2, 2015, pp. 23-25.
Vancouver Kayabaş A, Akgün AO, Atilla A, Güzel M, Erenler AK, Kefeli Gürses G. Panhypopituitarism Following Hemorrhagic Fever with Renal Syndrome Due to Hantavirus. Journal of Emergency Medicine Case Reports. 2015;6(2):23-5.