Elevated cerebrospinal fluid neopterin concentration is associated with disease severity in acute Puumala hantavirus infection.

Clin Dev Immunol 2013 31;2013:634632. Epub 2013 Jul 31.

Department of Internal Medicine, Oulu University Hospital, P.O. Box 20, 90029 Oulu, Finland.

Nephropathia epidemica (NE) caused by Puumala hantavirus (PUUV) is the most common hemorrhagic fever with renal syndrome (HFRS) in Europe. The infection activates immunological mechanisms that contribute to the pathogenesis and characteristics of the illness. In this study we measured cerebrospinal fluid (CSF) neopterin concentration from 23 acute-phase NE patients. We collected data on kidney function, markers of tissue permeability, haemodynamic properties, blood cell count, length of hospitalisation, inflammatory parameters, and ophthalmological properties. The neopterin levels were elevated (> 5.8 nmol/L) in 22 (96%) NE-patients (mean 45.8 nmol/L); these were especially high in patients with intrathecal PUUV-IgM production (mean 58.2 nmol/L, P = 0.01) and those with elevated CSF protein concentrations (mean 63.6 nmol/L, P < 0.05). We also observed a correlation between the neopterin and high plasma creatinine value (r = 0.66, P = 0.001), low blood thrombocyte count (r = -0.42, P < 0.05), and markedly disturbed refractory properties of an eye (r = 0.47, P < 0.05). Length of hospitalisation correlated with the neopterin (r = 0.42, P < 0.05; male patients r = 0.69, P < 0.01). Patients with signs of tissue oedema and increased permeability also had high neopterin concentrations. These results reinforce the view that PUUV-HFRS is a general infection that affects the central nervous system and the blood-brain barrier.

Download full-text PDF

Source
http://dx.doi.org/10.1155/2013/634632DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747491PMC
February 2014
117 Reads

Publication Analysis

Top Keywords

cerebrospinal fluid
8
neopterin concentration
8
puumala hantavirus
8
length hospitalisation
8
neopterin
6
concentrations 636 nmol/l
4
protein concentrations
4
elevated csf
4
csf protein
4
001 elevated
4
puuv-igm production
4
production 582 nmol/l
4
582 nmol/l 001
4
005
4
observed correlation
4
plasma creatinine
4
creatinine 066
4
066 0001
4
high plasma
4
neopterin high
4

Similar Publications