Hemorrhagic fever with renal syndrom

Linderhohn M, Ahlm C, Settergren B, et al. Elevated plasma levels of tumor necrosis factor (TNF)-a, soluble TNF receptors, interleukin (IL)-6, and IL-10 in patients with hemorrhagic fever with renal syndrome. J Infect Dis 1996 173 38-43. 

Hemorrhagic manifestations as in hemorrhagic fever with renal syndrome absent... 

Cyanide poisoning Ethylene glycol poisoning Hantavirus pulmonary syndrome Hemorrhagic fever with renal syndrome Lewisite poisoning Malaria... 

Ribavirin is a synthetic guanosine analogue, with in vitro activity against a broad spectrum of DNA and RNA viruses, and retroviruses, including HIV. Ribavirin has been used for treatment of a variety of viral infections, including respiratory syncytial virus bronchiolitis and pneumonia, measles, influenza types A and B, Lassa fever, hemorrhagic fever with renal syndrome (Hantaviruses), hepatitis C, and HIV infection. It is used commonly now along with interferon alpha for treatment of hepatitis C infection. There is no known direct nephrotoxicity of ribavirin. 

Intravenous and/or aerosol ribavirin has been used occasionally in treating severe influenza virus infection and in the treatment of immunosuppressedpatients with adenovirus, vaccinia, parainfluenza, or measles virus infections. Aerosolized ribavirin reduces duration of fever but has no other beneficial effects in influenza infections in hospitalized children. Intravenous ribavirin decreases mortality in Lassa fever and has been used in treating other arenavirus-related hemorrhagic fevers. Intravenous ribavirin is beneficial in hemorrhagic fever with renal syndrome owing to hantavirus infection but ineffective in hantavirus-associated cardiopulmonary syndrome or SARS. 

Hemorrhagic fever with renal syndrome (Hantaan, Seoul, Puumala viruses)... 

Lee HW. Hemorrhagic fever with renal syndrome in Korea. Rev Infect Dis. 1989 ll(May-Jun) S864-S876. 

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