{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:23:42Z","timestamp":1784179422658,"version":"3.55.0"},"reference-count":34,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,9,13]],"date-time":"2021-09-13T00:00:00Z","timestamp":1631491200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital","award":["5900\/3225"],"award-info":[{"award-number":["5900\/3225"]}]},{"name":"The Medical Research Fund of Sein\u00e4joki Central Hospital","award":["6000\/3231"],"award-info":[{"award-number":["6000\/3231"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Central and peripheral hormone deficiencies have been documented during and after acute hantavirus infection. Thrombocytopenia and coagulation abnormalities are common findings in haemorrhagic fever with renal syndrome (HFRS). The associations between coagulation and hormonal abnormalities in HFRS have not been studied yet. Forty-two patients diagnosed with Puumala virus (PUUV) infection were examined during the acute phase and on a follow-up visit approximately one month later. Hormonal defects were common during acute PUUV infection. Overt (clinical) hypogonadism was identified in 80% of the men and approximately 20% of the patients had overt hypothyroidism. At the one-month follow-up visit, six patients had central hormone deficits. Acute peripheral hormone deficits associated with a more severe acute kidney injury (AKI), longer hospital stay and more severe thrombocytopenia. Half of the patients with bleeding symptoms had also peripheral hormonal deficiencies. Patients with free thyroxine levels below the reference range had higher D-dimer level than patients with normal thyroid function, but no thromboembolic events occurred. Acute phase hormonal abnormalities associate with severe disease and altered haemostasis in PUUV infection.<\/jats:p>","DOI":"10.3390\/v13091818","type":"journal-article","created":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T03:46:14Z","timestamp":1631591174000},"page":"1818","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Hormonal Defects Are Common during Puumala Hantavirus Infection and Associate with Disease Severity and Biomarkers of Altered Haemostasis"],"prefix":"10.3390","volume":"13","author":[{"given":"Marlene","family":"Tarvainen","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland"},{"name":"Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland"},{"name":"Division of Internal Medicine, Sein\u00e4joki Central Hospital, 60220 Sein\u00e4joki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satu","family":"M\u00e4kel\u00e4","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland"},{"name":"Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Outi","family":"Laine","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland"},{"name":"Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4905-7564","authenticated-orcid":false,"given":"Ilkka","family":"P\u00f6rsti","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland"},{"name":"Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sari","family":"Risku","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, Sein\u00e4joki Central Hospital, 60220 Sein\u00e4joki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onni","family":"Niemel\u00e4","sequence":"additional","affiliation":[{"name":"Laboratory and Medical Research Unit, Sein\u00e4joki Central Hospital, 60220 Sein\u00e4joki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jukka","family":"Mustonen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland"},{"name":"Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8693-3498","authenticated-orcid":false,"given":"Pia","family":"Jaatinen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland"},{"name":"Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland"},{"name":"Division of Internal Medicine, Sein\u00e4joki Central Hospital, 60220 Sein\u00e4joki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1038\/nrmicro3066","article-title":"Uncovering the mysteries of hantavirus infections","volume":"11","author":"Vaheri","year":"2013","journal-title":"Nat. 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