SrasV1, Main, Exploration, bibRecord, 006388

Lung pathology of fatal severe acute respiratory syndrome

Identifieur interne : 006388 ( Main/Exploration ); précédent : 006387; suivant : 006389

Lung pathology of fatal severe acute respiratory syndrome

Auteurs : John M. Nicholls [République populaire de Chine] ; Leo L. M. Poon [République populaire de Chine] ; Kam C. Lee [Hong Kong] ; Wai F. Ng [Hong Kong] ; Sik T. Lai [Hong Kong] ; Chung Y. Leung [Hong Kong] ; Chung M. Chu [Hong Kong] ; Pak K. Hui [Hong Kong] ; Kong L. Mak [Hong Kong] ; Wilina Lim [Hong Kong] ; Kin W. Yan [Hong Kong] ; Kwok H. Chan [République populaire de Chine] ; Ngai C. Tsang [Hong Kong] ; YI GUAN [République populaire de Chine] ; Kwok Y. Yuen [République populaire de Chine] ; J. S. Malik Peiris [République populaire de Chine]

Source :

Lancet : (British edition) [ 0140-6736 ] ; 2003.

RBID : Pascal:03-0368361

Descripteurs français

KwdFr :
- Adulte, Adulte d'âge moyen, Biopsie, Bronches (anatomopathologie), Cellules géantes (ultrastructure), Femelle, Humains, Issue fatale, Mâle, Métaplasie, Noyau de la cellule (ultrastructure), Poumon (anatomopathologie), Poumon (virologie), Syndrome respiratoire aigu sévère (), Syndrome respiratoire aigu sévère (anatomopathologie), Syndrome respiratoire aigu sévère (virologie), Taille d'organe, Virus du SRAS (isolement et purification).
MESH :
- anatomopathologie : Bronches, Poumon, Syndrome respiratoire aigu sévère.
- isolement et purification : Virus du SRAS.
- virologie : Poumon, Syndrome respiratoire aigu sévère.
Pascal (Inist)
- Adulte, Adulte d'âge moyen, Biopsie, Cellules géantes, Femelle, Humains, Issue fatale, Mâle, Métaplasie, Noyau de la cellule, Pneumopathie, Aigu, Syndrome, Evolution, Mort, Autopsie, Poumon, Coronavirus, Réaction chaîne polymérase RT, Immunohistochimie, Syndrome respiratoire aigu sévère, Sérologie, Microscope électronique, Taille d'organe.
Wicri :
- topic : Mort.

English descriptors

KwdEn :
- Acute, Adult, Autopsy, Biopsy, Bronchi (pathology), Cell Nucleus (ultrastructure), Coronavirus, Death, Electron microscope, Evolution, Fatal Outcome, Female, Giant Cells (ultrastructure), Humans, Immunohistochemistry, Lung, Lung (pathology), Lung (virology), Male, Metaplasia, Middle Aged, Organ Size, Pneumopathy, Reverse transcription polymerase chain reaction, SARS Virus (isolation & purification), Serology, Severe Acute Respiratory Syndrome (complications), Severe Acute Respiratory Syndrome (pathology), Severe Acute Respiratory Syndrome (virology), Syndrome.
MESH :
- complications : Severe Acute Respiratory Syndrome.
- isolation & purification : SARS Virus.
- pathology : Bronchi, Lung, Severe Acute Respiratory Syndrome.
- ultrastructure : Cell Nucleus, Giant Cells.
- virology : Lung, Severe Acute Respiratory Syndrome.
- Adult, Biopsy, Fatal Outcome, Female, Humans, Male, Metaplasia, Middle Aged, Organ Size.

Abstract

Background Severe acute respiratory syndrome (SARS) is a novel infectious disease with global impact. A virus from the family Coronaviridae has been identified as the cause, but the pathogenesis is still unclear. Methods Post-mortem tissue samples from six patients who died from SARS in February and March, 2003, and an open lung biopsy from one of these patients were studied by histology and virology. Only one full autopsy was done. Evidence of infection with the SARS-associated coronavirus (SARS-CoV) and human metapneumovirus was sought by reverse-transcriptase PCR and serology. Pathological samples were examined by light and electron microscopy and immunohistochemistry. Findings All six patients had serological evidence of recent infection with SARS-CoV. Diffuse alveolar damage was common but not universal. Morphological changes identified were bronchial epithelial denudation, loss of cilia, and squamous metaplasia. Secondary bacterial pneumonia was present in one case. A giant-cell infiltrate was seen in four patients, with a pronounced increase in macrophages in the alveoli and the interstitium of the lung. Haemophagocytosis was present in two patients. The alveolar pneumocytes also showed cytomegaly with granular amphophilic cytoplasm. The patient for whom full autopsy was done had atrophy of the white pulp of the spleen. Electron microscopy revealed viral particles in the cytoplasm of epithelial cells corresponding to coronavirus. Interpretation SARS is associated with epithelial-cell proliferation and an increase in macrophages in the lung. The presence of haemophagocytosis supports the contention that cytokine dysregulation may account, at least partly, for the severity of the clinical disease. The case definition of SARS should acknowledge the range of lung pathology associated with this disease.

Affiliations:

Hong Kong, République populaire de Chine

Le document en format XML

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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Lung pathology of fatal severe acute respiratory syndrome</title>
<author><name sortKey="Nicholls, John M" sort="Nicholls, John M" uniqKey="Nicholls J" first="John M." last="Nicholls">John M. Nicholls</name>
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<s3>CHN</s3>
<sZ>1 aut.</sZ>
</inist:fA14>
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<wicri:noRegion>Department of Pathology, University of Hong Kong, Hong Kong Special Administrative Region</wicri:noRegion>
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<author><name sortKey="Poon, Leo L M" sort="Poon, Leo L M" uniqKey="Poon L" first="Leo L. M." last="Poon">Leo L. M. Poon</name>
<affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Microbiology, University of Hong Kong, Hong Kong Special Administrative Region</s1>
<s3>CHN</s3>
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<wicri:noRegion>Department of Microbiology, University of Hong Kong, Hong Kong Special Administrative Region</wicri:noRegion>
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<author><name sortKey="Lee, Kam C" sort="Lee, Kam C" uniqKey="Lee K" first="Kam C." last="Lee">Kam C. Lee</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Pathology and Medicine, Princess Margaret Hospital</s1>
<s2>Kowloon</s2>
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<author><name sortKey="Ng, Wai F" sort="Ng, Wai F" uniqKey="Ng W" first="Wai F." last="Ng">Wai F. Ng</name>
<affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Department of Pathology, Yan Chai Hospital</s1>
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<wicri:noRegion>Kowloon</wicri:noRegion>
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<author><name sortKey="Lai, Sik T" sort="Lai, Sik T" uniqKey="Lai S" first="Sik T." last="Lai">Sik T. Lai</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Pathology and Medicine, Princess Margaret Hospital</s1>
<s2>Kowloon</s2>
<s3>HKG</s3>
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<author><name sortKey="Leung, Chung Y" sort="Leung, Chung Y" uniqKey="Leung C" first="Chung Y." last="Leung">Chung Y. Leung</name>
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<author><name sortKey="Chu, Chung M" sort="Chu, Chung M" uniqKey="Chu C" first="Chung M." last="Chu">Chung M. Chu</name>
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<author><name sortKey="Hui, Pak K" sort="Hui, Pak K" uniqKey="Hui P" first="Pak K." last="Hui">Pak K. Hui</name>
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<author><name sortKey="Mak, Kong L" sort="Mak, Kong L" uniqKey="Mak K" first="Kong L." last="Mak">Kong L. Mak</name>
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<country>Hong Kong</country>
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<author><name sortKey="Lim, Wilina" sort="Lim, Wilina" uniqKey="Lim W" first="Wilina" last="Lim">Wilina Lim</name>
<affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Government Virus Unit</s1>
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<s3>HKG</s3>
<sZ>10 aut.</sZ>
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<author><name sortKey="Yan, Kin W" sort="Yan, Kin W" uniqKey="Yan K" first="Kin W." last="Yan">Kin W. Yan</name>
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<author><name sortKey="Chan, Kwok H" sort="Chan, Kwok H" uniqKey="Chan K" first="Kwok H." last="Chan">Kwok H. Chan</name>
<affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Microbiology, University of Hong Kong, Hong Kong Special Administrative Region</s1>
<s3>CHN</s3>
<sZ>2 aut.</sZ>
<sZ>12 aut.</sZ>
<sZ>14 aut.</sZ>
<sZ>15 aut.</sZ>
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<wicri:noRegion>Department of Microbiology, University of Hong Kong, Hong Kong Special Administrative Region</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Tsang, Ngai C" sort="Tsang, Ngai C" uniqKey="Tsang N" first="Ngai C." last="Tsang">Ngai C. Tsang</name>
<affiliation wicri:level="1"><inist:fA14 i1="10"><s1>Department of Microbiology, Queen Elizabeth Hospital</s1>
<s2>Kowloon</s2>
<s3>HKG</s3>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>Hong Kong</country>
<wicri:noRegion>Kowloon</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Yi Guan" sort="Yi Guan" uniqKey="Yi Guan" last="Yi Guan">YI GUAN</name>
<affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Microbiology, University of Hong Kong, Hong Kong Special Administrative Region</s1>
<s3>CHN</s3>
<sZ>2 aut.</sZ>
<sZ>12 aut.</sZ>
<sZ>14 aut.</sZ>
<sZ>15 aut.</sZ>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>République populaire de Chine</country>
<wicri:noRegion>Department of Microbiology, University of Hong Kong, Hong Kong Special Administrative Region</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Yuen, Kwok Y" sort="Yuen, Kwok Y" uniqKey="Yuen K" first="Kwok Y." last="Yuen">Kwok Y. Yuen</name>
<affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Microbiology, University of Hong Kong, Hong Kong Special Administrative Region</s1>
<s3>CHN</s3>
<sZ>2 aut.</sZ>
<sZ>12 aut.</sZ>
<sZ>14 aut.</sZ>
<sZ>15 aut.</sZ>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>République populaire de Chine</country>
<wicri:noRegion>Department of Microbiology, University of Hong Kong, Hong Kong Special Administrative Region</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Peiris, J S Malik" sort="Peiris, J S Malik" uniqKey="Peiris J" first="J. S. Malik" last="Peiris">J. S. Malik Peiris</name>
<affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Microbiology, University of Hong Kong, Hong Kong Special Administrative Region</s1>
<s3>CHN</s3>
<sZ>2 aut.</sZ>
<sZ>12 aut.</sZ>
<sZ>14 aut.</sZ>
<sZ>15 aut.</sZ>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>République populaire de Chine</country>
<wicri:noRegion>Department of Microbiology, University of Hong Kong, Hong Kong Special Administrative Region</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">Lancet : (British edition)</title>
<title level="j" type="abbreviated">Lancet : (Br. ed.)</title>
<idno type="ISSN">0140-6736</idno>
<imprint><date when="2003">2003</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">Lancet : (British edition)</title>
<title level="j" type="abbreviated">Lancet : (Br. ed.)</title>
<idno type="ISSN">0140-6736</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Acute</term>
<term>Adult</term>
<term>Autopsy</term>
<term>Biopsy</term>
<term>Bronchi (pathology)</term>
<term>Cell Nucleus (ultrastructure)</term>
<term>Coronavirus</term>
<term>Death</term>
<term>Electron microscope</term>
<term>Evolution</term>
<term>Fatal Outcome</term>
<term>Female</term>
<term>Giant Cells (ultrastructure)</term>
<term>Humans</term>
<term>Immunohistochemistry</term>
<term>Lung</term>
<term>Lung (pathology)</term>
<term>Lung (virology)</term>
<term>Male</term>
<term>Metaplasia</term>
<term>Middle Aged</term>
<term>Organ Size</term>
<term>Pneumopathy</term>
<term>Reverse transcription polymerase chain reaction</term>
<term>SARS Virus (isolation & purification)</term>
<term>Serology</term>
<term>Severe Acute Respiratory Syndrome (complications)</term>
<term>Severe Acute Respiratory Syndrome (pathology)</term>
<term>Severe Acute Respiratory Syndrome (virology)</term>
<term>Syndrome</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Biopsie</term>
<term>Bronches (anatomopathologie)</term>
<term>Cellules géantes (ultrastructure)</term>
<term>Femelle</term>
<term>Humains</term>
<term>Issue fatale</term>
<term>Mâle</term>
<term>Métaplasie</term>
<term>Noyau de la cellule (ultrastructure)</term>
<term>Poumon (anatomopathologie)</term>
<term>Poumon (virologie)</term>
<term>Syndrome respiratoire aigu sévère ()</term>
<term>Syndrome respiratoire aigu sévère (anatomopathologie)</term>
<term>Syndrome respiratoire aigu sévère (virologie)</term>
<term>Taille d'organe</term>
<term>Virus du SRAS (isolement et purification)</term>
</keywords>
<keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Bronches</term>
<term>Poumon</term>
<term>Syndrome respiratoire aigu sévère</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Severe Acute Respiratory Syndrome</term>
</keywords>
<keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>SARS Virus</term>
</keywords>
<keywords scheme="MESH" qualifier="isolement et purification" xml:lang="fr"><term>Virus du SRAS</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Bronchi</term>
<term>Lung</term>
<term>Severe Acute Respiratory Syndrome</term>
</keywords>
<keywords scheme="MESH" qualifier="ultrastructure" xml:lang="en"><term>Cell Nucleus</term>
<term>Giant Cells</term>
</keywords>
<keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Poumon</term>
<term>Syndrome respiratoire aigu sévère</term>
</keywords>
<keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Lung</term>
<term>Severe Acute Respiratory Syndrome</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Biopsy</term>
<term>Fatal Outcome</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Metaplasia</term>
<term>Middle Aged</term>
<term>Organ Size</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Biopsie</term>
<term>Cellules géantes</term>
<term>Femelle</term>
<term>Humains</term>
<term>Issue fatale</term>
<term>Mâle</term>
<term>Métaplasie</term>
<term>Noyau de la cellule</term>
<term>Pneumopathie</term>
<term>Aigu</term>
<term>Syndrome</term>
<term>Evolution</term>
<term>Mort</term>
<term>Autopsie</term>
<term>Poumon</term>
<term>Coronavirus</term>
<term>Réaction chaîne polymérase RT</term>
<term>Immunohistochimie</term>
<term>Syndrome respiratoire aigu sévère</term>
<term>Sérologie</term>
<term>Microscope électronique</term>
<term>Taille d'organe</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Mort</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Background Severe acute respiratory syndrome (SARS) is a novel infectious disease with global impact. A virus from the family Coronaviridae has been identified as the cause, but the pathogenesis is still unclear. Methods Post-mortem tissue samples from six patients who died from SARS in February and March, 2003, and an open lung biopsy from one of these patients were studied by histology and virology. Only one full autopsy was done. Evidence of infection with the SARS-associated coronavirus (SARS-CoV) and human metapneumovirus was sought by reverse-transcriptase PCR and serology. Pathological samples were examined by light and electron microscopy and immunohistochemistry. Findings All six patients had serological evidence of recent infection with SARS-CoV. Diffuse alveolar damage was common but not universal. Morphological changes identified were bronchial epithelial denudation, loss of cilia, and squamous metaplasia. Secondary bacterial pneumonia was present in one case. A giant-cell infiltrate was seen in four patients, with a pronounced increase in macrophages in the alveoli and the interstitium of the lung. Haemophagocytosis was present in two patients. The alveolar pneumocytes also showed cytomegaly with granular amphophilic cytoplasm. The patient for whom full autopsy was done had atrophy of the white pulp of the spleen. Electron microscopy revealed viral particles in the cytoplasm of epithelial cells corresponding to coronavirus. Interpretation SARS is associated with epithelial-cell proliferation and an increase in macrophages in the lung. The presence of haemophagocytosis supports the contention that cytokine dysregulation may account, at least partly, for the severity of the clinical disease. The case definition of SARS should acknowledge the range of lung pathology associated with this disease.</div>
</front>
</TEI>
<affiliations><list><country><li>Hong Kong</li>
<li>République populaire de Chine</li>
</country>
</list>
<tree><country name="République populaire de Chine"><noRegion><name sortKey="Nicholls, John M" sort="Nicholls, John M" uniqKey="Nicholls J" first="John M." last="Nicholls">John M. Nicholls</name>
</noRegion>
<name sortKey="Chan, Kwok H" sort="Chan, Kwok H" uniqKey="Chan K" first="Kwok H." last="Chan">Kwok H. Chan</name>
<name sortKey="Peiris, J S Malik" sort="Peiris, J S Malik" uniqKey="Peiris J" first="J. S. Malik" last="Peiris">J. S. Malik Peiris</name>
<name sortKey="Poon, Leo L M" sort="Poon, Leo L M" uniqKey="Poon L" first="Leo L. M." last="Poon">Leo L. M. Poon</name>
<name sortKey="Yi Guan" sort="Yi Guan" uniqKey="Yi Guan" last="Yi Guan">YI GUAN</name>
<name sortKey="Yuen, Kwok Y" sort="Yuen, Kwok Y" uniqKey="Yuen K" first="Kwok Y." last="Yuen">Kwok Y. Yuen</name>
</country>
<country name="Hong Kong"><noRegion><name sortKey="Lee, Kam C" sort="Lee, Kam C" uniqKey="Lee K" first="Kam C." last="Lee">Kam C. Lee</name>
</noRegion>
<name sortKey="Chu, Chung M" sort="Chu, Chung M" uniqKey="Chu C" first="Chung M." last="Chu">Chung M. Chu</name>
<name sortKey="Hui, Pak K" sort="Hui, Pak K" uniqKey="Hui P" first="Pak K." last="Hui">Pak K. Hui</name>
<name sortKey="Lai, Sik T" sort="Lai, Sik T" uniqKey="Lai S" first="Sik T." last="Lai">Sik T. Lai</name>
<name sortKey="Leung, Chung Y" sort="Leung, Chung Y" uniqKey="Leung C" first="Chung Y." last="Leung">Chung Y. Leung</name>
<name sortKey="Lim, Wilina" sort="Lim, Wilina" uniqKey="Lim W" first="Wilina" last="Lim">Wilina Lim</name>
<name sortKey="Mak, Kong L" sort="Mak, Kong L" uniqKey="Mak K" first="Kong L." last="Mak">Kong L. Mak</name>
<name sortKey="Ng, Wai F" sort="Ng, Wai F" uniqKey="Ng W" first="Wai F." last="Ng">Wai F. Ng</name>
<name sortKey="Tsang, Ngai C" sort="Tsang, Ngai C" uniqKey="Tsang N" first="Ngai C." last="Tsang">Ngai C. Tsang</name>
<name sortKey="Yan, Kin W" sort="Yan, Kin W" uniqKey="Yan K" first="Kin W." last="Yan">Kin W. Yan</name>
</country>
</tree>
</affiliations>
</record>

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Lung pathology of fatal severe acute respiratory syndrome

Lung pathology of fatal severe acute respiratory syndrome

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