INCREASED PRODUCTION OF NITRIC-OXIDE IN PATIENTS INFECTED WITH THE EUROPEAN VARIANT OF HANTAVIRUS

Serum nitrate levels, a measure of nitric oxide (NO) production in viv o, were very high (95 +/- 14 mu M) in 13 patients infected with Puumal a virus, the European variant of Hantavirus (HTV), as compared to thos e in healthy subjects (33 +/- 3 mu M). Serum nitrate levels showed a h igh and significant correlation with scores on the Acute Physiological And Chronic Health Evaluation (APACHE II) scale and with serum creati nine, and an inverse correlation with platelet counts. Serial serum me asurements of nitrate in 2 severe cases showed very high levels at the onset of arterial hypotension and acute renal failure. We conclude th at excessive amounts of NO are produced in patients infected with Puum ala virus and that this reactive nitrogen intermediate could play an i mportant role in the pathogenesis of the disease.