Intestinal protein loss in patients with haemorrhagic fever with renal syndrome

Background. In haemorrhagic fever with renal drome (HFRS) vascular dysfunct ion has been observed in various organs, but the involvement of the intesti ne has not yet been reported. This study was performed to evaluate the asso ciation of intestinal protein loss in this disease with other clinical para meters reflecting vascular permeability or disease severity Methods. Twenty patients with HFRS were included in this study. Intestinal protein loss was measured by Tc-99m-human serum albumin (Tc-99m-HSA) scinti graphy in the acute stage, and quantitative analysis of protein loss was me asured by the faecal clearance of alpha 1-antitrypsin (C-AT) in the acute a nd the recovery stages. C-AT was then compared with clinical parameters ref lecting disease activity and vascular permeability. Results. Tc-99m-HSA scintigraphy was positive in 13 (65%) patients, and C-A T in the acute stage was significantly increased as compared with C-AT in t he recovery stage (40,5 +/- 24.1 vs 9.2 +/- 4.2 ml/day, P < 0.001). C-AT wa s associated with serum albumin levers, frequency of hypotensive episodes, severity of acute renal failure, and degree of thrombocytopenia. Conclusions. Our data suggest that the increased vascular permeability of H FRS is associated with the increased intestinal loss of plasma proteins, wh ich might represent one of the parameters of disease severity in HFRS.