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• W2374054310 abstract "Objective To study the pathological changes and pathogenesis of fatal severe acute respiratory syndrome (SARS). Methods Complete autopsy was performed in 6 SARS cases in Beijing. Systemic examinations were carried out by naked eyes, light microscopy, immunohistochemistry, electron microscopy, and in situ hybridization. Results It was found that SARS-CoV attack different tissues in various organs, including endothelial cells of capillaries, pulmonary alvolar type Ⅱ pneumocytes, lymphocytes and macrophages in lymph node and spleen, epithelial cells of renal tubule (especial distal tubule), mucosal epithelial cells and lymphocytes of alimentary tract, cardiac myocytes by electron microscopy. SARS-CoV genome were identified in epithelial cells of trachea and bronchus, pulmonary alveolar type Ⅱ pneumocytes, lymphocytes and macrophages in lymph node and spleen, endothelial cells of capillaries, mucosal epithelial cells and lymphocytes of alimentary tract, epithelial cells of distal renal tubule by in situ hybridization. Respiratory system and immune system were most severely damaged in fatal SARS patients. Diffuse alveolar damage (DAD) was basic pathological finding in fatal SARS patients. Exudation, proliferation and fibrosis were observed in the involved lungs. Exudation seemed to occur in early stage. In this stage, air spaces were filled with inflammatory exudates (including protein, fibrin, mononuclear cells, lymphocytes, even red cells), hyaline membrane was formed along the alveolar walls. Proliferation changes happened subsequently, desquamative alveolitis was the characteristic changes in the stage. Fibrosis was the late change. The organization of protein exudates and hyaline membrane resulted in intra-alveolar fibrosis and thickening of the alveolar septa. Atrophy of lymphoid tissues was the obvious changes in spleens and lymph nodes. Both T cell and B cell, especially T cell, ppoulations were decreased greatly. The germinal centers were burnt-out. Some activated atypical cells, positive by in situ hybridization, were observed in spleens and lymph nodes. However, the immune phenotype were unknown. Such specials were named SARS by us. Degeneration and even necrosis of cardiac myocytes occurred in 2 cases. Fatty degeneration of the central area in liver lobules occurred in all cases, but only 2 cases with necrosis in the same area were found. Aspergillosis in the lungs were founded in 3 cases.Conclusions Fatal SARS is a respiratory infectious disease involved different tissues in multiple organs in which respiratory system and immune system were most severely damaged." @default.
• W2374054310 created "2016-06-24" @default.
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• W2374054310 date "2003-01-01" @default.
• W2374054310 modified "2023-09-23" @default.
• W2374054310 title "Pathological changes and pathogenesis of fatal severe acute respiratory syndrome" @default.
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