Pulmonary pathological features in coronavirus associated severe acute respiratory syndrome (SARS)
Identifieur interne : 005736 ( Main/Exploration ); précédent : 005735; suivant : 005737Pulmonary pathological features in coronavirus associated severe acute respiratory syndrome (SARS)
Auteurs : G M-K Tse [Hong Kong] ; K-F To [Hong Kong] ; P K-S Chan [Hong Kong] ; A W I. Lo [Hong Kong] ; K-C Ng [Hong Kong] ; A. Wu [Hong Kong] ; N. Lee [Hong Kong] ; H-C Wong [Hong Kong] ; S-M Mak ; K-F Chan [Hong Kong] ; D S C. Hui [Hong Kong] ; J J-Y Sung [Hong Kong] ; H-K Ng [Hong Kong]Source :
- Journal of Clinical Pathology [ 0021-9746 ] ; 2004-03.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Alvéoles pulmonaires (anatomopathologie), Cellules cultivées, Coronavirus (isolement et purification), Division cellulaire, Femelle, Humains, Immunohistochimie (), Microscopie électronique, Mâle, Noyau de la cellule (anatomopathologie), Poumon (anatomopathologie), Poumon (virologie), Sujet âgé, Sujet âgé de 80 ans ou plus, Syndrome respiratoire aigu sévère (anatomopathologie), Syndrome respiratoire aigu sévère (virologie).
- MESH :
- anatomopathologie : Alvéoles pulmonaires, Noyau de la cellule, Poumon, Syndrome respiratoire aigu sévère.
- isolement et purification : Coronavirus.
- virologie : Poumon, Syndrome respiratoire aigu sévère.
- Pascal (Inist)
- MESH :
English descriptors
- KwdEn :
- Adult, Aged, Aged, 80 and over, Anatomic pathology, BOOP, bronchiolitis obliterans organising pneumonia, CMV, cytomegalovirus, CXR, chest x ray, Cell Division, Cell Nucleus (pathology), Cells, Cultured, CoV, coronavirus, Coronavirus, Coronavirus (isolation & purification), DAD, diffuse alveolar damage, EM, electron microscopy, Female, HSV, herpes simplex virus, Humans, Immunohistochemistry (methods), Lung (pathology), Lung (virology), Male, Microscopy, Electron, Middle Aged, Pulmonary Alveoli (pathology), SARS, severe acute respiratory syndrome, Severe Acute Respiratory Syndrome (pathology), Severe Acute Respiratory Syndrome (virology), Severe acute respiratory syndrome, coronavirus, pulmonary, severe acute respiratory syndrome.
- MESH :
- isolation & purification : Coronavirus.
- methods : Immunohistochemistry.
- pathology : Cell Nucleus, Lung, Pulmonary Alveoli, Severe Acute Respiratory Syndrome.
- virology : Lung, Severe Acute Respiratory Syndrome.
- Teeft :
- Adult, Aged, Aged, 80 and over, Airspace, Alveolar spaces, Appropriate lung, Atypical pneumocytes, Autoimmune response, Cell Division, Cell marker, Cell surface, Cells, Cultured, Cellular organising plugs, Cellular pathology, Chan, Chinese university, Clin pathol, Clinical features, Coronavirus, Cytopathic effect, Cytoplasmic vesicles, Dako, Diffuse alveolar damage, Electron microscopy, Endoplasmic reticulum, Eosin, Eosin stain, Extensive consolidation, Fatal cases, Female, First index case, Haematoxylin, Herpes simplex virus, Histiocyte, Histological features, Hong kong, Humans, Hyaline membrane, Index patient, Infectious disease, Interstitial fibrosis, Lesion, Lung injury, Lung pathology, Male, Microscopy, Electron, Middle Aged, Multinuclear cells, Multinucleated, Multinucleated pneumocytes, Novel coronavirus, Organising, Original magnification, Other cell types, Parainfluenza viruses, Pathological features, Pneumocytes, Positive correlation, Postmortem, Postmortem examination, Postmortem lung tissues, Postmortem tissues, Primary syndrome, Primary target, Pulmonary fibrosis, Pulmonary oedema, Pulmonary pathology, Respiratory syncytial virus, Respiratory syndrome, Sars, Small airways, Subpleural region, Such lesions, Syndrome, Ultrastructural, Ultrastructural examination, Unconfirmed cases, Vero cell culture, Viral, Viral isolation, Viral particles, Virological investigations, Wales hospital, World health organisation, Worldwide outbreak.
Abstract
Background: Severe acute respiratory syndrome (SARS) became a worldwide outbreak with a mortality of 9.2%. This new human emergent infectious disease is dominated by severe lower respiratory illness and is aetiologically linked to a new coronavirus (SARS-CoV). Methods: Pulmonary pathology and clinical correlates were investigated in seven patients who died of SARS in whom there was a strong epidemiological link. Investigations include a review of clinical features, morphological assessment, histochemical and immunohistochemical stainings, ultrastructural study, and virological investigations in postmortem tissue. Results: Positive viral culture for coronavirus was detected in most premortem nasopharyngeal aspirate specimens (five of six) and postmortem lung tissues (two of seven). Viral particles, consistent with coronavirus, could be detected in lung pneumocytes in most of the patients. These features suggested that pneumocytes are probably the primary target of infection. The pathological features were dominated by diffuse alveolar damage, with the presence of multinucleated pneumocytes. Fibrogranulation tissue proliferation in small airways and airspaces (bronchiolitis obliterans organising pneumonia-like lesions) in subpleural locations was also seen in some patients. Conclusions: Viable SARS-CoV could be isolated from postmortem tissues. Postmortem examination allows tissue to be sampled for virological investigations and ultrastructural examination, and when coupled with the appropriate lung morphological changes, is valuable to confirm the diagnosis of SARS-CoV, particularly in clinically unapparent or suspicious but unconfirmed cases.
Url:
DOI: 10.1136/jcp.2003.013276
Affiliations:
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Lo</name><affiliation wicri:level="4"><orgName type="university">Université chinoise de Hong Kong</orgName><country>Hong Kong</country><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author><author><name sortKey="Ng, K C" sort="Ng, K C" uniqKey="Ng K" first="K-C" last="Ng">K-C Ng</name><affiliation wicri:level="4"><orgName type="university">Université chinoise de Hong Kong</orgName><country>Hong Kong</country><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author><author><name sortKey="Wu, A" sort="Wu, A" uniqKey="Wu A" first="A" last="Wu">A. Wu</name><affiliation wicri:level="4"><orgName type="university">Université chinoise de Hong Kong</orgName><country>Hong Kong</country><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author><author><name sortKey="Lee, N" sort="Lee, N" uniqKey="Lee N" first="N" last="Lee">N. Lee</name><affiliation wicri:level="4"><orgName type="university">Université chinoise de Hong Kong</orgName><country>Hong Kong</country><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author><author><name sortKey="Wong, H C" sort="Wong, H C" uniqKey="Wong H" first="H-C" last="Wong">H-C Wong</name><affiliation wicri:level="4"><orgName type="university">Université chinoise de Hong Kong</orgName><country>Hong Kong</country><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author><author><name sortKey="Mak, S M" sort="Mak, S M" uniqKey="Mak S" first="S-M" last="Mak">S-M Mak</name><affiliation><wicri:noCountry code="subField">SAR</wicri:noCountry></affiliation></author><author><name sortKey="Chan, K F" sort="Chan, K F" uniqKey="Chan K" first="K-F" last="Chan">K-F Chan</name><affiliation wicri:level="4"><orgName type="university">Université chinoise de Hong Kong</orgName><country>Hong Kong</country><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author><author><name sortKey="Hui, D S C" sort="Hui, D S C" uniqKey="Hui D" first="D S C" last="Hui">D S C. Hui</name><affiliation wicri:level="4"><orgName type="university">Université chinoise de Hong Kong</orgName><country>Hong Kong</country><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author><author><name sortKey="Sung, J J Y" sort="Sung, J J Y" uniqKey="Sung J" first="J J-Y" last="Sung">J J-Y Sung</name><affiliation wicri:level="4"><orgName type="university">Université chinoise de Hong Kong</orgName><country>Hong Kong</country><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author><author><name sortKey="Ng, H K" sort="Ng, H K" uniqKey="Ng H" first="H-K" last="Ng">H-K Ng</name><affiliation wicri:level="4"><orgName type="university">Université chinoise de Hong Kong</orgName><country>Hong Kong</country><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Clinical Pathology</title><title level="j" type="abbrev">J Clin Pathol</title><idno type="ISSN">0021-9746</idno><idno type="eISSN">1472-4146</idno><imprint><publisher>BMJ Publishing Group Ltd and Association of Clinical Pathologists</publisher><date type="published" when="2004-03">2004-03</date><biblScope unit="volume">57</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="260">260</biblScope></imprint><idno type="ISSN">0021-9746</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0021-9746</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Anatomic pathology</term><term>BOOP, bronchiolitis obliterans organising pneumonia</term><term>CMV, cytomegalovirus</term><term>CXR, chest x ray</term><term>Cell Division</term><term>Cell Nucleus (pathology)</term><term>Cells, Cultured</term><term>CoV, coronavirus</term><term>Coronavirus</term><term>Coronavirus (isolation & purification)</term><term>DAD, diffuse alveolar damage</term><term>EM, electron microscopy</term><term>Female</term><term>HSV, herpes simplex virus</term><term>Humans</term><term>Immunohistochemistry (methods)</term><term>Lung (pathology)</term><term>Lung (virology)</term><term>Male</term><term>Microscopy, Electron</term><term>Middle Aged</term><term>Pulmonary Alveoli (pathology)</term><term>SARS, severe acute respiratory syndrome</term><term>Severe Acute Respiratory Syndrome (pathology)</term><term>Severe Acute Respiratory Syndrome (virology)</term><term>Severe acute respiratory syndrome</term><term>coronavirus</term><term>pulmonary</term><term>severe acute respiratory syndrome</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Alvéoles pulmonaires (anatomopathologie)</term><term>Cellules cultivées</term><term>Coronavirus (isolement et purification)</term><term>Division cellulaire</term><term>Femelle</term><term>Humains</term><term>Immunohistochimie ()</term><term>Microscopie électronique</term><term>Mâle</term><term>Noyau de la cellule (anatomopathologie)</term><term>Poumon (anatomopathologie)</term><term>Poumon (virologie)</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Syndrome respiratoire aigu sévère (anatomopathologie)</term><term>Syndrome respiratoire aigu sévère (virologie)</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Alvéoles pulmonaires</term><term>Noyau de la cellule</term><term>Poumon</term><term>Syndrome respiratoire aigu sévère</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Coronavirus</term></keywords><keywords scheme="MESH" qualifier="isolement et purification" xml:lang="fr"><term>Coronavirus</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Immunohistochemistry</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Cell Nucleus</term><term>Lung</term><term>Pulmonary Alveoli</term><term>Severe Acute Respiratory Syndrome</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="Pascal" xml:lang="fr"><term>Anatomopathologie</term><term>Coronavirus</term><term>Syndrome respiratoire aigu sévère</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Airspace</term><term>Alveolar spaces</term><term>Appropriate lung</term><term>Atypical pneumocytes</term><term>Autoimmune response</term><term>Cell Division</term><term>Cell marker</term><term>Cell surface</term><term>Cells, Cultured</term><term>Cellular organising plugs</term><term>Cellular pathology</term><term>Chan</term><term>Chinese university</term><term>Clin pathol</term><term>Clinical features</term><term>Coronavirus</term><term>Cytopathic effect</term><term>Cytoplasmic vesicles</term><term>Dako</term><term>Diffuse alveolar damage</term><term>Electron microscopy</term><term>Endoplasmic reticulum</term><term>Eosin</term><term>Eosin stain</term><term>Extensive consolidation</term><term>Fatal cases</term><term>Female</term><term>First index case</term><term>Haematoxylin</term><term>Herpes simplex virus</term><term>Histiocyte</term><term>Histological features</term><term>Hong kong</term><term>Humans</term><term>Hyaline membrane</term><term>Index patient</term><term>Infectious disease</term><term>Interstitial fibrosis</term><term>Lesion</term><term>Lung injury</term><term>Lung pathology</term><term>Male</term><term>Microscopy, Electron</term><term>Middle Aged</term><term>Multinuclear cells</term><term>Multinucleated</term><term>Multinucleated pneumocytes</term><term>Novel coronavirus</term><term>Organising</term><term>Original magnification</term><term>Other cell types</term><term>Parainfluenza viruses</term><term>Pathological features</term><term>Pneumocytes</term><term>Positive correlation</term><term>Postmortem</term><term>Postmortem examination</term><term>Postmortem lung tissues</term><term>Postmortem tissues</term><term>Primary syndrome</term><term>Primary target</term><term>Pulmonary fibrosis</term><term>Pulmonary oedema</term><term>Pulmonary pathology</term><term>Respiratory syncytial virus</term><term>Respiratory syndrome</term><term>Sars</term><term>Small airways</term><term>Subpleural region</term><term>Such lesions</term><term>Syndrome</term><term>Ultrastructural</term><term>Ultrastructural examination</term><term>Unconfirmed cases</term><term>Vero cell culture</term><term>Viral</term><term>Viral isolation</term><term>Viral particles</term><term>Virological investigations</term><term>Wales hospital</term><term>World health organisation</term><term>Worldwide outbreak</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Cellules cultivées</term><term>Division cellulaire</term><term>Femelle</term><term>Humains</term><term>Immunohistochimie</term><term>Microscopie électronique</term><term>Mâle</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: Severe acute respiratory syndrome (SARS) became a worldwide outbreak with a mortality of 9.2%. This new human emergent infectious disease is dominated by severe lower respiratory illness and is aetiologically linked to a new coronavirus (SARS-CoV). Methods: Pulmonary pathology and clinical correlates were investigated in seven patients who died of SARS in whom there was a strong epidemiological link. Investigations include a review of clinical features, morphological assessment, histochemical and immunohistochemical stainings, ultrastructural study, and virological investigations in postmortem tissue. Results: Positive viral culture for coronavirus was detected in most premortem nasopharyngeal aspirate specimens (five of six) and postmortem lung tissues (two of seven). Viral particles, consistent with coronavirus, could be detected in lung pneumocytes in most of the patients. These features suggested that pneumocytes are probably the primary target of infection. The pathological features were dominated by diffuse alveolar damage, with the presence of multinucleated pneumocytes. Fibrogranulation tissue proliferation in small airways and airspaces (bronchiolitis obliterans organising pneumonia-like lesions) in subpleural locations was also seen in some patients. Conclusions: Viable SARS-CoV could be isolated from postmortem tissues. Postmortem examination allows tissue to be sampled for virological investigations and ultrastructural examination, and when coupled with the appropriate lung morphological changes, is valuable to confirm the diagnosis of SARS-CoV, particularly in clinically unapparent or suspicious but unconfirmed cases.</div></front></TEI><affiliations><list><country><li>Hong Kong</li></country><settlement><li>Sha Tin</li></settlement><orgName><li>Université chinoise de Hong Kong</li></orgName></list><tree><noCountry><name sortKey="Mak, S M" sort="Mak, S M" uniqKey="Mak S" first="S-M" last="Mak">S-M Mak</name></noCountry><country name="Hong Kong"><noRegion><name sortKey="Tse, G M K" sort="Tse, G M K" uniqKey="Tse G" first="G M-K" last="Tse">G M-K Tse</name></noRegion><name sortKey="Chan, K F" sort="Chan, K F" uniqKey="Chan K" first="K-F" last="Chan">K-F Chan</name><name sortKey="Chan, P K S" sort="Chan, P K S" uniqKey="Chan P" first="P K-S" last="Chan">P K-S Chan</name><name sortKey="Hui, D S C" sort="Hui, D S C" uniqKey="Hui D" first="D S C" last="Hui">D S C. Hui</name><name sortKey="Lee, N" sort="Lee, N" uniqKey="Lee N" first="N" last="Lee">N. Lee</name><name sortKey="Lo, A W I" sort="Lo, A W I" uniqKey="Lo A" first="A W I" last="Lo">A W I. Lo</name><name sortKey="Ng, H K" sort="Ng, H K" uniqKey="Ng H" first="H-K" last="Ng">H-K Ng</name><name sortKey="Ng, K C" sort="Ng, K C" uniqKey="Ng K" first="K-C" last="Ng">K-C Ng</name><name sortKey="Sung, J J Y" sort="Sung, J J Y" uniqKey="Sung J" first="J J-Y" last="Sung">J J-Y Sung</name><name sortKey="To, K F" sort="To, K F" uniqKey="To K" first="K-F" last="To">K-F To</name><name sortKey="Wong, H C" sort="Wong, H C" uniqKey="Wong H" first="H-C" last="Wong">H-C Wong</name><name sortKey="Wu, A" sort="Wu, A" uniqKey="Wu A" first="A" last="Wu">A. Wu</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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