LIVER INVOLVEMENT IN HEMORRHAGIC-FEVER WITH RENAL SYNDROME

Hemorrhagic fever with renal syndrome is an acute febrile nephropathy caused by several viruses of the genus Hantavirus of the family Bunyav iridae. During the past 8 years, 32 cases of hemorrhagic fever with re nal syndrome have been diagnosed. Nine out of the 32 patients (28%) ha d raised (twofold upper normal limits) transaminases during hospitaliz ation. Four out of the nine patients (44%) died. In contrast, only thr ee out of the 23 patients (13%) without raised transaminases died. Fiv e patients had slightly increased serum alkaline phosphatase and gamma -glutamyl-transpeptidase, whereas six patients had prolonged prothromb in time. Liver histology showed midzonal necrosis in hepatic lobules w ith extravasation of red cells and mild mononuclear infiltrate. Liver involvement seems to be an ominous prognostic factor in such patients and is correlated with severe renal failure and thrombocytopenia.