Hemorrhagic fever with renal syndrome complicated by reversible secondary hyperparathyroidism during renal recovery: a case report.

Hemorrhagic fever with renal syndrome (HFRS) is a hantavirus-induced zoonosis characterized by fever, hemorrhagic manifestations, and acute kidney injury (AKI). Endocrine sequelae have been increasingly recognized after HFRS, yet parathyroid dysfunction has rarely been reported. Secondary hyperparathyroidism (SHPT) is classically associated with chronic kidney disease, but severe AKI may also disrupt mineral metabolism and trigger abnormal parathyroid hormone (PTH) responses. In this study, we report a case of secondary hyperparathyroidism suspected to be triggered by hemorrhagic fever with renal syndrome, a presentation that has been rarely described in the literature. In addition, we provide a review of the existing evidence regarding endocrine involvement in HFRS.