Human cytomegalovirus as a direct pathogen: Correlation of multiorgan involvement and cell distribution with clinical and pathological findings in a case of congenital inclusion disease

被引:81
作者
Bissinger, AL
Sinzger, C
Kaiserling, E
Jahn, G
机构
[1] Univ Tubingen, Inst Med Virol & Epidemiol Viruskrankheiten, D-72076 Tubingen, Germany
[2] Univ Tubingen, Inst Pathol, D-72076 Tubingen, Germany
关键词
human cytomegalovirus(HCMV); congenital infection; congenital inclusion disease; immunohistochemistry; pathogenesis;
D O I
10.1002/jmv.2208
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
The human cytomegalovirus (HCMV), a member of the Herpesviridae, is the most frequent cause of congenital virus infections and a major cause of morbidity and mortality in immunocompromised patients. Due to the lack of an appropriate animal model, insight into the pathogenesis of HCMV infections originates primarily from in situ examination of HCMV-infected tissues. Although in immunocompromised adults such tests are complicated frequently by the presence of additional misleading pathogens, the absence of additional pathogens renders congenital inclusion disease the most suitable access for investigation of pathogenetic aspects of HCMV infections. Immunohistochemical examination of tissue sections from a boy with fatal congenital inclusion disease was undertaken to detect the extent of multiorgan and cell involvement. Adrenal gland, bone marrow, diencephalon, heart, kidney, liver, lung, pancreas, placenta, small bowel and spleen were included in this study. Detection of virus antigens from different phases of viral replication revealed that all investigated organs were infected by HCMV. Simultaneous detection of cell type specific marker molecules showed that a variety of cell types stained positive for HCMV antigens including endothelial cells, epithelial cells, smooth muscle cells, mesenchymal cells, hepatocytes, monocytes/macrophages and granulocytes. The lung, the pancreas, the kidneys and the liver were the major target organs with a high number of HCMV infected cells. This correlated with multiorgan failure as the cause of death and strongly indicates direct pathogenetic effects of HCMV. (C) 2002 Wiley-Liss, Inc.
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页码:200 / 206
页数:7
相关论文
共 37 条
[1]  
Ahlfors K, 1999, SCAND J INFECT DIS, V31, P443, DOI 10.1080/00365549950163969
[2]  
ALFORD CA, 1990, REV INFECT DIS, V12, P745
[3]   Quantitation of cytomegalovirus: Methodologic aspects and clinical applications [J].
Boeckh, M ;
Boivin, G .
CLINICAL MICROBIOLOGY REVIEWS, 1998, 11 (03) :533-+
[4]   Symptomatic congenital cytomegalovirus infection in infants born to mothers with preexisting immunity to cytomegalovirus [J].
Boppana, SB ;
Fowler, KB ;
Britt, WJ ;
Stagno, S ;
Pass, RF .
PEDIATRICS, 1999, 104 (01) :55-60
[5]   SYMPTOMATIC CONGENITAL CYTOMEGALOVIRUS-INFECTION - NEONATAL MORBIDITY AND MORTALITY [J].
BOPPANA, SB ;
PASS, RF ;
BRITT, WJ ;
STAGNO, S ;
ALFORD, CA .
PEDIATRIC INFECTIOUS DISEASE JOURNAL, 1992, 11 (02) :93-99
[6]  
BRITT WJ, 1996, FIELDS VIROLOGY, P2493
[7]   EARLY CLINICAL MANIFESTATIONS AND INTELLECTUAL OUTCOME IN CHILDREN WITH SYMPTOMATIC CONGENITAL CYTOMEGALOVIRUS-INFECTION [J].
CONBOY, TJ ;
PASS, RF ;
STAGNO, S ;
ALFORD, CA ;
MYERS, GJ ;
BRITT, WJ ;
MCCOLLISTER, FP ;
SUMMERS, MN ;
MCFARLAND, CE ;
BOLL, TJ .
JOURNAL OF PEDIATRICS, 1987, 111 (03) :343-348
[8]   Summary of the II International Symposium on Cytomegalovirus [J].
de Jong, MD ;
Galasso, GJ ;
Gazzard, B ;
Griffiths, PD ;
Jabs, DA ;
Kern, ER ;
Spector, SA .
ANTIVIRAL RESEARCH, 1998, 39 (03) :141-162
[9]  
Eggers M, 1998, J MED VIROL, V56, P351, DOI 10.1002/(SICI)1096-9071(199812)56:4&lt
[10]  
351::AID-JMV11&gt