In order to clarify the pathogenesis of hemorrhagic fever with renal syndrome (HFRS), we detected HFRS virus structural proteins expressed in perepheral blood mononuclear cells (PBMC) by using immunohistochemical technique. Meanwhile we also determined plasma endothelin (ET), substance P (SP) and some sensitive markers of renal function with radioimmunoassay. The result showed that in HFRS patients, from the day of admission up to the thirteenth day of illness, the antigens of HFRS virus membrane protein (MP) and nucleocapsid (NP) could simultaneously be found in PBMC, though their expressive degree gradually decreased when the condition of the patients became better. Based on the external appearance and nucleus pattern of PBMC we recognized the MP and NP positive cells were mainly monocytes among which only a few presented faint IgM and C3 stain. On admission there was difference in expressive intensity between MP and NP. The MP expressive intensity was in parallel with plasma ET/SP ratio, the general condition and the severity of renal damage. These data suggest that HFRS virus can invade PBMC, replicate in them, and express their structural proteins. MP may be related with the pathogenesis of HFRS virus and the increase of plasma ET/SP ratio may be an important factor aggravating kidney injury.