Association between proteinuria and interleukin 2 in Hemorrhagic fever with renal syndrome

초록

Hemorrhagic fever with renal syndrome (HFRS) is a disease caused by a virus which develops acute renal failure (ARF) and severe proteinuria during clinical course. There are many controversies about pathogenesis of disturbed renal function during its course, but it largely remains unknown. Recently renal biopsy findings in HFRS indicate that T lymphocytes infiltrated in renal interstitium may associate with abnormal renal function and proteinuria. Therefore, for the evaluation of T-cell dysfunction, we measured interleukin 2 (IL-2) in serum and urine in oliguric and diuretic phase of patients who showed typically clinical manifestation of HFRS and course of ARF. (1.) In HFRS patients, 24 hour proteinuria in the oliguric phase (731.6 106.9 mg/dl) was significantly higher than in the diuretic phase (499.9 275.2mg/dL; P = 0.0009) and also significantly higher than control group(36.5 8.6 mg/dl; P = 0.0000). (2.) There was no significant difference in serum IL-2 between oliguric and diuretic phase, but there was significant difference compared with control group, respectively. (3.) The measurement of urine IL-2 of HFRS patients in the oliguric phase was significantly higher than patients in the diuretic phase (0.35 0.05fmol/mgCr) and control group (0.78 0.27 fmollmgCr) (P < 0.05). (4.) In oliguric phase of HFRS patients serum IL-2 and 24 hour proteinuria showed linear relationship (r = 0.64,P = 0.09) and creatinine clearance and urine IL-2 showed reverse relationship (r = 0.73, P = 0.04). Withthe above results, we consider that pathophysiology of abnormal renal function is associated with IL-2 secreted by T lymphocytes inifitratingin renal interstitium and we also presume that IL-2 has certain effects inproteinuria.