Hypophyseal Hemorrhage and Panhypopituitarism during Puumala Virus Infection: Magnetic Resonance Imaging and Detection of Viral Antigen in the Hypophysis

We describe 3 cases of nephropathia epidemica (NE) that confirm that Puumala virus infection may cause hypophyseal injury. Autopsy revealed a hemorrhagic hypophysis positive for Puumala virus antigen in both neuroendocrine stromal and vascular endothelial cells in 1 patient, and 2 patients developed...

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Bibliographic Details
Published in:Clinical infectious diseases 2002-07, Vol.35 (1), p.96-101
Main Authors: Hautala, Timo, Sironen, Tarja, Vapalahti, Olli, Pääkkö, Eija, Särkioja, Terttu, Salmela, Pasi I., Vaheri, Antti, Plyusnin, Alexander, Kauma, Heikki
Format: Article
Language:English
Subjects:
Adult
Antibodies
Antigens, Viral - analysis
Biological and medical sciences
Brief Reports
Endocrine cells
Endocrinopathies
Endothelial cells
Hemorrhage
Hemorrhage - diagnosis
Hemorrhage - etiology
Hemorrhage - virology
Hemorrhagic fever with renal syndrome
Hemorrhagic Fever with Renal Syndrome - diagnosis
Hemorrhagic Fever with Renal Syndrome - physiopathology
Human viral diseases
Humans
Hypopituitarism - diagnosis
Hypopituitarism - etiology
Hypopituitarism - virology
Hypothalamus. Hypophysis. Epiphysis (diseases)
Infections
Infectious diseases
Kidneys
Magnetic Resonance Imaging
Male
Medical sciences
Middle Aged
Neuroglia
Non tumoral diseases. Target tissue resistance. Benign neoplasms
Pituitary Diseases - diagnosis
Pituitary Diseases - etiology
Pituitary Diseases - virology
Pituitary gland
Pituitary Gland - virology
Puumala virus
Viral diseases
Viral diseases of the nervous system
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Summary:We describe 3 cases of nephropathia epidemica (NE) that confirm that Puumala virus infection may cause hypophyseal injury. Autopsy revealed a hemorrhagic hypophysis positive for Puumala virus antigen in both neuroendocrine stromal and vascular endothelial cells in 1 patient, and 2 patients developed hypophyseal hemorrhage (diagnosed with magnetic resonance imaging) during or shortly after acute NE, both of whom developed panhypopituitarism.
ISSN:1058-4838
1537-6591
DOI:10.1086/340859