Mild Course of Hemorrhagic Fever with Renal Syndrome in A Patient with HLA-B27 Positive-Spondylarthritis

Hemorrhagic fever with renal syndrome (HFRS) is an acute infectious disease of viral etiology, the main complication of which is severe kidney damage. The disease is characterized by a cyclic course, there are 4 periods (febrile, oliguric, polyuric, recollection). In Russia, the disease occurs almost everywhere, but endemic areas are the Far East, the Urals, and the Volga region. In the pathogenesis of the disease, the greatest significance is the development of vascular endothelial damage, where virus reproduction occurs, leading to increased permeability of the vascular wall with the development of hemorrhagic syndrome, edema. In addition, hemorrhages are promoted by a decrease in coagulation factors, as well as platelets. Cases of mild course of this disease in patients carrying the human leukocyte antigen (HLA)-B27 allele have been described in the literature. The aim of our article is to demonstrate a clinical case of mild course of HFRS in a patient with spondyloarthritis associated with HLA-B27. The patient presented with prolonged subfebrileitis as well as inguinal lymphadenopathy. The disease proceeded without kidney damage, development of hemorrhagic syndrome, which are characteristic manifestations of HFRS. Detected IgG and IgM to hantaviruses (causative agents of HFRS) confirmed the diagnosis. The patient had spondyloarthritis associated with HLA-B27, which, according to the literature, can make the clinical picture less vivid, which is observed in our case. Pathogenetic treatment with glucocorticoids resulted in regression of complaints and improvement of the patient’s condition. This article will be useful for specialists of different profiles, as the clinical picture of HFRS has many nonspecific symptoms that can be considered as manifestations of various diseases.