The purpose of the study the clinical picture of a «new» infection — ixodic Lyme borreliosis caused by B. miyamotoi. The work is based on the results of a prospective observation of 76 patients with disease caused by B. miyamotoi. Diagnosis is confirmed by PCR. The study shows that a syndrome of fever and a manifestation of intoxication — headache, fatigue, myalgia, vomiting and other substances are at the heart of a typical clinical picture. In some cases, for unclear reasons, the pathological process involves internal organs — lungs, liver, kidney, gastrointestinal tract, heart. This fact may be the cause of a diagnostic error.

Peculiarities of the course and diagnosis of hemorrhagic fever with renal sуndrome in Udmurt Republic are studied by the analysis of 583 case records of patients treated from 1990 to 1999 in the urban dialysis center of the medicosanitary department of the Izhmach and other hospitals of Izhevsk. This disease on the territory of Udmurtiya is characterized by severity of the course and sometimes warrants dialysis. The analysis of toxic manifestations makes it possible to predict severity of the course of hemorrhagic fever with renal syndrome in preoliguric period and to determine treatment tactics including the use of replacing therapy.

AIM:To characterize nephropathy in patients recovering after hemorrhagic fever with renal syndrome (HFRS) using functional loading tests.MATERIALS AND METHODS:In 65 HFRS convalescents we examined renal function under water deprivation, exercises and studied intraglomerular hemodynamics.RESULTS:After 2-month follow-up renal functional reserve was absent in 34% of the convalescents indicating intraglomerular hypertension. Under water deprivation most of the patients showed persistent tubulointerstitial disorders. Submaximal muscular exercises aggravated glomerular and tubular dysfunction manifesting with microalbuminuria, increased excretory beta 2-microglobulin fraction, low concentration reserve.CONCLUSION:Functional loading tests provide more detailed characterization of renal function in HFRS convalescents.

Laboratory and functional tests were made in 50 convalescents who had suffered hemorrhagic fever with renal syndrome (HFRS). It is shown that nephropathy in such patients runs with a decline in renal functional reserve indicative of intraglomerular hypertension, impaired ability of the kidneys for osmotic urine concentration, defective tubular reabsorption of beta 2-microglobulin, microcirculatory disorders, collagen disbolism, high levels of uric acid in the blood. The occurrence of hyperuricemia and intraglomerular hypertension in HFRS convalescents calls for special consideration as leading nonimmune factors of nephropathy progression.

Рассматривается эффективность преднизолонотерапии в остром периоде геморрагической лихорадки с почечным синдромом. Прослежены исходы этого заболевания в динамике через 1, 3, 6, 9, 12 мес., 2—3 года и 6—8 лет у 40 больных со среднетяжелой и у 30 больных с тяжелой формой заболевания. Констатировано, что преднизолон оказывает положительный эффект на сокращение сроков купирования симптомов интоксикации, исчезновение патологических элементов из осадка мочи в остром периоде и на сроки восстановления функционального состояния почек в отдаленном периоде.

The effectiveness of prednisolone therapy in the acute period of hemorrhagic fever with renal syndrome is considered. The outcomes of this disease were traced in dynamics after 1, 3, 6, 9, 12 months, 2-3 years and 6-8 years in 40 patients with moderate and 30 patients with severe disease. It was stated that prednisolone has a positive effect on reducing the timing of relief of symptoms of intoxication, the disappearance of pathological elements from urine sediment in the acute period and on the timing of restoration of the functional state of the kidneys in the long term.