Clin Infect Dis 2002 Jul 6;35(1):96-101. Epub 2002 Jun 6.
Department of Internal Medicine, University of Oulu, Oulu, FIN-90014 Oulu, Finland.
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.