Hemorrhagic fever-renal syndrome

What it is

From: Orphanet

A rare rodent-borne, potentially severe, hemorrhagic disease caused by Old World Hantaviruses characterized by high fever, malaise, headache, myalgia, arthralgia, backache, abdominal pain, oliguria/renal failure and systemic hemorrhagic manifestations.

Reported clinical features and what the terms mean

The following findings are associated with this condition in Orphanet. They are not a checklist for diagnosing yourself, and they do not all occur in every affected person. Some are examination, imaging or laboratory findings that cannot be recognised at home.

The frequency labels describe how often a finding was reported among people with the condition in the source. They do not give the chance that a person with that symptom has the condition. Definitions below reproduce HPO terminology; they explain the term, not the likely severity in an individual.

Acute kidney injury · Very frequent (99-80%)

Sudden loss of renal function, as manifested by decreased urine production, and a rise in serum creatinine or blood urea nitrogen concentration (azotemia).

Capillary leak · Very frequent (99-80%)

An acute phenomenon characterized by hypotension and anasarca due to the loss of plasma volume into peripheral tissues, with evidence of decreased plasma volume (hemoconcentration) and protein loss from the intravascular space (hypoalbuminemia) during acute episodes.

Decreased glomerular filtration rate · Very frequent (99-80%)

An abnormal reduction in the volume of fluid filtered out of plasma through glomerular capillary walls into Bowman's capsules per unit of time.

Decreased urine output · Very frequent (99-80%)

A decreased rate of urine production.

Elevated circulating creatinine concentration · Very frequent (99-80%)

An increased amount of creatinine in the blood.

Fever · Very frequent (99-80%)

Body temperature elevated above the normal range.

Oliguria · Very frequent (99-80%)

Low output of urine, clinically classified as an output below 300-500ml/day.

Severe infection · Very frequent (99-80%)

A type of infection that is regarded as a sign of a pathological susceptibility to infection because of unusual severity or intensity of the infection.

Abdominal pain · Frequent (79-30%)

An unpleasant sensation characterized by physical discomfort (such as pricking, throbbing, or aching) and perceived to originate in the abdomen.

Acute tubulointerstitial nephritis · Frequent (79-30%)

Acute inflammation of the kidney affecting the interstitium of the kidneys surrounding the tubules.

Back pain · Frequent (79-30%)

An unpleasant sensation characterized by physical discomfort (such as pricking, throbbing, or aching) localized to the back.

Blurred vision · Frequent (79-30%)

Lack of sharpness of vision resulting in the inability to see fine detail.

Chills · Frequent (79-30%)

A sudden sensation of feeling cold.

Decreased body weight · Frequent (79-30%)

Abnormally low body weight.

Other findings in the same source

From: Orphanet

Additional reported features include Excessive daytime somnolence (Frequent (79-30%)); Fatigue (Frequent (79-30%)); Glomerulonephritis (Frequent (79-30%)); Headache (Frequent (79-30%)); Hypotension (Frequent (79-30%)); Increased circulating interleukin 6 concentration (Frequent (79-30%)); Increased total leukocyte count (Frequent (79-30%)); Muscle weakness (Frequent (79-30%)); Myalgia (Frequent (79-30%)); Nausea (Frequent (79-30%)). This is a selected summary, not a complete description of the condition.

When it may begin

From: Orphanet

All ages

Inheritance in the source

From: Orphanet

Not applicable

Frequency and the population described

From: Orphanet

Annual incidence: 1-9 / 1 000 000; Europe; Value and class. Annual incidence: 1-9 / 100 000; Slovenia; Value and class. Annual incidence: 1-9 / 100 000; Sweden; Value and class. Annual incidence: 1-9 / 1 000 000; Norway; Value and class.

Which doctor should you see?

The suggested department for discussing Hemorrhagic fever-renal syndrome is Infectious Diseases, with a general physician / infectious disease specialist as the relevant type of clinician. General physician / Family Medicine; paediatrician for children. Referral depends on symptoms.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• Which exposure or organism is suspected, and what evidence would confirm it?
• Are precautions, vaccination or advice for close contacts relevant to this infection?
• What should happen if symptoms worsen or do not improve as expected?

Treatment discussions and follow-up

The material gathered for this draft does not provide a complete condition-specific treatment pathway for Hemorrhagic fever-renal syndrome. That gap does not mean that treatment is unavailable. A clinician needs to establish the diagnosis and review current guidance before recommending medicines, procedures, rehabilitation or other support.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

The collected references do not establish a complete prevention or long-term outlook section for this entry. Missing information should not be interpreted as proof that prevention is impossible or that a particular outcome is inevitable. Ask what is known for the exact subtype, stage and personal circumstances, and which uncertainties remain.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.