Journal Article

Plasma Exchange—Associated Immunoglobulin M—Negative Hantavirus Disease after a Camping Holiday in Southern France

Els Keyaerts, Erik Ghijsels, Philippe Lemey, Piet Maes, Pierre Zachée, Ronald Daelemans, Tony Vervoort, Gerhard Mertens, Marc Van Ranst and Jan Clement

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 38, issue 10, pages 1350-1356
Published in print May 2004 | ISSN: 1058-4838
Published online May 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/383311
Plasma Exchange—Associated Immunoglobulin M—Negative Hantavirus Disease after a Camping Holiday in Southern France

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A 37-year-old Belgian patient presented with acute nephropathia epidemica (NE) shortly after a camping holiday in southern France. Unusual symptoms were initial noncardiogenic lung involvement, followed by severe acute renal failure, acute acalculous cholecystitis, presence of immunoblasts in the bone marrow, and hemolytic anemia, presenting as hemolytic uremic syndrome. Positive immunoglobulin (Ig) A and rising IgG titers against Puumala hantavirus (PUUV) were detected, but IgM remained negative on days 8 and 20. The results of reverse-transcriptase–polymerase chain reaction performed on day 8 were positive for PUUV. This is the first report of an iatrogenically IgM-negative hantavirus case due to the selective removal of heavy-weight molecules during plasma exchange via the centrifugation technique. This is also the first report of proven NE from the Mediterranean part of France.

Journal Article.  3755 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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