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    The degree of leukocytosis and urine GATA-3 mRNA levels are risk factors for severe acute kidney injury in Puumala virus nephropathia epidemica

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    Authors
    Libraty, Daniel H.
    Makela, Satu
    Vlk, Jennifer
    Hurme, Mikko
    Vaheri, Antti
    Ennis, Francis A.
    Mustonen, Jukka
    UMass Chan Affiliations
    Division of Infectious Diseases and Immunology, Department of Medicine
    Document Type
    Journal Article
    Publication Date
    2012-04-16
    Keywords
    Immunity
    Immunology and Infectious Disease
    Immunology of Infectious Disease
    Infectious Disease
    
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    Abstract
    Puumala hantavirus (PUUV) infection, also known as nephropathia epidemica, is the most common cause of hemorrhagic fever with renal syndrome (HFRS) in Europe. The pathogenesis of PUUV nephropathia epidemica is complex and multifactorial, and the risk factors for severe acute kidney injury (AKI) during acute PUUV infection are not well defined. We conducted a prospective study of hospitalized patients with PUUV infection in Tampere, Finland to identify acute illness risk factors for HFRS severity. Serial daily blood and urine samples were collected throughout acute illness and at 2 week and 6 month convalescent visits. By univariate analyses, the maximum white blood cell count during acute illness was a risk factor for severe AKI. There were no significant associations between PUUV-induced AKI severity and platelet counts, C-reactive protein, or alanine aminotransferase levels. Maximum plasma interleukin (IL)-6, urine IL-6, and urine IL-8 concentrations were positively associated with PUUV-induced AKI. Finally, the maximum urinary sediment GATA-3 mRNA level was positively correlated with the peak fold-change in serum creatinine, regardless of AKI severity classification. By multivariate analyses, we found that the maximum levels of leukocytes and urinary sediment GATA-3 mRNA during acute illness were independent risk factors for severe PUUV-induced AKI. We have identified novel acute illness risk factors for severe PUUV-induced AKI.
    Source
    PLoS One. 2012;7(4):e35402. doi: 10.1371/journal.pone.0035402. Epub 2012 Apr 16. Link to article on publisher's site
    DOI
    10.1371/journal.pone.0035402
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/35019
    PubMed ID
    22523590
    Related Resources
    Link to Article in PubMed
    Rights
    Copyright: © 2012 Libraty et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
    ae974a485f413a2113503eed53cd6c53
    10.1371/journal.pone.0035402
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