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- Title
Dobrava hantavirus and coinciding SARS-CoV-2 infection mimicking thrombotic microangiopathy and responding to a single dose of eculizumab.
- Authors
Aberger, Simon; Kozakowski, Nicolas; Proházka, Zoltán; Pleininger, Thomas; Salmhofer, Hermann
- Abstract
The current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has refocused scientific interest on gaining insight into the pathophysiology of systemic viral diseases. Complement activation has been characterized as a driver of endothelial injury and microvascular thrombosis in acute respiratory distress syndrome as well as hantavirus hemorrhagic fever with renal syndrome. On this occasion, we wish to report a case of severe hantavirus disease with coinciding SARS-CoV-2 infection mimicking thrombotic microangiopathy with rapid response of inflammatory markers, hematologic parameters and proteinuria to eculizumab. These findings support a disease model of virus-associated endothelial injury involving alternative pathway complement activation. Future studies are needed to explore whether end organ damage can be mitigated by complement inhibition in life-threatening viral disease.
- Subjects
SARS-CoV-2; HEMORRHAGIC fever with renal syndrome; THROMBOTIC thrombocytopenic purpura; HANTAVIRUS diseases; VIRUS diseases; ADULT respiratory distress syndrome
- Publication
Clinical Kidney Journal, 2023, Vol 16, Issue 12, p2750
- ISSN
2048-8505
- Publication type
Article
- DOI
10.1093/ckj/sfad222