Distinguishing between hantavirus-induced haemorrhagic fever with renal syndrome and pregnancy-induced liver pathologies (AFLP and HELLP syndromes.

To the editor: In their recent article, Macé et al. pointed appropriately to the many disturbing clinical similarities between haemorrhagic fever with renal syndrome (HFRS) due to Seoul virus (SEOV) infection – an emerging zoonosis – and two pregnancy-related pathologies affecting mainly the liver, acute fatty liver of pregnancy (AFLP) syndrome and haemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome [1]. At present, HFRS is one of the most frequent, but still heavily underestimated, forms of acute infectious kidney injury, with up to 200,000 cases per year worldwide. Moreover, SEOV affects not only the kidneys, but also often the liver as well [2].