Systemic inflammation in hemorrhagic fever with renal syndrome correlates with hypotension and thrombocytopenia but not with renal injury

Systemic inflammation is common in patients with nephropathia epidemica (NE ), a European form of hemorrhagic fever. Markers of inflammation were studi ed in a patient with NE with respiratory insufficiency (patient 1), 18 othe r patients with NE, and 13 patients with a viral infectious disease other t han NE. Neutrophil and monocyte CD11b expression levels, determined by flow cytometry; soluble interleukin (IL)-2 receptor (sIL-2R), IL-6, and IL-8 co ncentrations, determined by means of Immulite; and soluble E-selectin, dete rmined by ELISA, were higher in patients with NE than in healthy subjects. The findings were not specific for NE and did not correlate with serum crea tinine levels, but the findings correlated inversely with mean arterial pre ssure (sIL-2R and monocyte CD11b expression) and minimum platelet count (sI L-2R, IL-6, neutrophil, and monocyte CD11b expression). Monocyte CD11b expr ession in patient 1 was extremely high, suggesting that monocytes may contr ibute to development of lung injury. Severity of inflammation in patients w ith NE is related to hypotension and platelet consumption but not to renal injury.