TNF and Hermansky-Pudlak syndrome: Although most data are from patients with HFRS/HPS, immunohistochemical staining and gene polymorphism studies showed an association of pro-inflammatory cytokines and disease in PUUV infection with significantly elevated serum levels of TNF-α, IL-6, IL-2 and IFN-γ in blood and urine [2,14,15].