{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:50:46Z","timestamp":1788915046529,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,9,14]],"date-time":"2015-09-14T00:00:00Z","timestamp":1442188800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Oulu University Hospital EVO-grants"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Nephropathia epidemica (<jats:styled-content style=\"fixed-case\">NE<\/jats:styled-content>) is a haemorrhagic fever with renal syndrome (<jats:styled-content style=\"fixed-case\">HFRS<\/jats:styled-content>) caused by Puumala hantavirus (<jats:styled-content style=\"fixed-case\">PUUV<\/jats:styled-content>). Pituitary haemorrhage and hypopituitarism may complicate recovery from acute <jats:styled-content style=\"fixed-case\">NE<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Forty\u2010seven of our recent cohort of 58 <jats:styled-content style=\"fixed-case\">NE<\/jats:styled-content> patients volunteered to be re\u2010examined in order to estimate the burden of hormonal deficiency 4 to 8\u00a0years after the acute illness. Two patients had suffered from pituitary haemorrhage, but many others exhibited pituitary oedema during their acute infection. In this study, we searched for symptoms of hormonal deficiency, performed hormonal laboratory screening, and most patients underwent pituitary <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> examination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The pituitary size had diminished in all patients in whom <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> was performed (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b7001). One patient with acute phase haemorrhage had made a complete recovery while the other continued to require hormonal substitution. In addition, hormonal laboratory abnormalities were observed in nine other patients; these being attributable to several reasons, for example independent peripheral hormonal diseases, side effects of medication or other secondary causes such as obesity. None of them had signs of late\u2010onset pituitary insufficiency caused by their previous <jats:styled-content style=\"fixed-case\">NE<\/jats:styled-content>. Health\u2010related quality of life (mean and median 15D score) of patients was comparable to that of age\u2010standardized general population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>None of our patients had developed obvious late\u2010onset hypopituitarism despite of the fact that pituitary gland can be affected during acute <jats:styled-content style=\"fixed-case\">NE<\/jats:styled-content>. We recommend requesting a history of hantavirus infection whenever the possibility of pituitary dysfunction is suspected at least in patients originating from regions with high <jats:styled-content style=\"fixed-case\">NE<\/jats:styled-content> infection rate.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.12863","type":"journal-article","created":{"date-parts":[[2015,7,23]],"date-time":"2015-07-23T08:10:13Z","timestamp":1437639013000},"page":"85-91","source":"Crossref","is-referenced-by-count":24,"title":["Long\u2010term hormonal follow\u2010up after human Puumala hantavirus infection"],"prefix":"10.1111","volume":"84","author":[{"given":"Terhi","family":"Partanen","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Oulu University Hospital Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minna","family":"Koivikko","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Oulu University Hospital Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e4ivi","family":"Leisti","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Oulu University Hospital Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasi","family":"Salmela","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Oulu University Hospital Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eija","family":"P\u00e4\u00e4kk\u00f6","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology Oulu University Hospital Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ari","family":"Karttunen","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology Oulu University Hospital Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harri","family":"Sintonen","sequence":"additional","affiliation":[{"name":"Department of Public Health University of Helsinki Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Risteli","sequence":"additional","affiliation":[{"name":"Nordlab Oulu Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Hautala","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Oulu University Hospital Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olli","family":"Vapalahti","sequence":"additional","affiliation":[{"name":"Department of Virology University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antti","family":"Vaheri","sequence":"additional","affiliation":[{"name":"Department of Virology University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heikki","family":"Kauma","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Oulu University Hospital Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Hautala","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Oulu University Hospital Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,9,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/rmv.1722"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000314657"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.1992.tb00555.x"},{"key":"e_1_2_7_5_1","first-page":"175","article-title":"Pituitary hemorrhage as a complication of hantaviral disease","volume":"16","author":"Suh D.C.","year":"1995","journal-title":"AJNR American Journal of Neuroradiology"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365549509047057"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1086\/340859"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2007.08.008"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000186883"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1385\/ENDO:26:2:079"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-0311"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-010-0918-y"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/07853890.2010.480979"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.3109\/07853890109002086"},{"key":"e_1_2_7_15_1","unstructured":"Sintonen H.(2014) [http:\/\/www.15d-instrument.net\/15d]."},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc7084"},{"key":"e_1_2_7_17_1","unstructured":"Koskinen S. 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