Hypopituitarism after Orthohantavirus Infection
Autor: | Danny Noack, Barry Rockx, Marco Goeijenbier, Linda van Schinkel, Els van Nood, Soerajja Bhoelan, Eric C. M. van Gorp, Thomas Langerak |
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Přispěvatelé: | Virology, Internal Medicine |
Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
0301 basic medicine
Orthohantavirus Pediatrics medicine.medical_specialty Pituitary gland Hypophysitis lcsh:QR1-502 030209 endocrinology & metabolism Review Hypopituitarism endocrine disturbances Puumala virus lcsh:Microbiology Pathogenesis 03 medical and health sciences 0302 clinical medicine Virology Humans Medicine Endocrine system biology business.industry medicine.disease biology.organism_classification Pathophysiology 030104 developmental biology Infectious Diseases medicine.anatomical_structure hypopituitarism Hemorrhagic Fever with Renal Syndrome Pituitary Gland HFRS business Complication |
Zdroj: | Viruses Viruses, Vol 11, Iss 4, p 340 (2019) Viruses, 11(4):340. Multidisciplinary Digital Publishing Institute (MDPI) |
ISSN: | 1999-4915 |
Popis: | Several case reports have described hypopituitarism following orthohantavirus infection, mostly following Puumala virus. The pathogenesis of this seemingly rare complication of orthohantavirus infection remains unknown. This review explores the possible pathophysiological mechanisms of pituitary damage due to orthohantavirus infection. In only three out of the 28 reported cases, hypopituitarism was detected during active infection. In the remaining cases, detection of pituitary damage was delayed, varying from two months up to thirteen months post-infection. In these cases, hypopituitarism remained undetected during the acute phase of infection or only occurred weeks to months post infection. Both ischemic and hemorrhagic damage of the pituitary gland have been detected in radiographic imaging and post-mortem studies in the studied case reports series. Ischemic damage could be caused by hypotension and/or vasospasms during the acute phase of hemorrhagic fever with renal syndrome (HFRS) while hemorrhage could be caused by thrombocytopenia, thrombopathy, and other known causes of coagulation disorders during orthohantavirus infection. Also, hypophysitis due to the presence of auto-antibodies have been suggested in the literature. In conclusion, a significant number of case reports and series describe hypopituitarism after orthohantavirus infection. In most cases hypopituitarism was diagnosed with a delay and therefore could very well be underreported. Clinicians should be aware of this potential endocrine complication, with substantial morbidity, and if unrecognized, significant mortality. |
Databáze: | OpenAIRE |
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