流行性出血熱（韓国型出血熱）の病理 ― 剖検所見を中心として ―
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概要
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The pathologic changes in a fatal case of laboratory type of Korean hemorrhagic fever was studied with the light and electron microscopy and immunohistologic techniques. The most characteristic features were (1) multiple hemorrhage in the mouth, myocardium and lung, (2) multiple focal necrosis and fibrosis in the liver, skeletal muscles, pancreas, salivary glands, etc., (3) infarct-like necrosis in the anterior lobe of the pituitary gland. The lung showed diffuse interstitial pneumonia with marked edema, hemorrhage and partial bronchopneumonia. Many old and new necrotic areas were present in the heart muscles with severe fresh bleeding. In the lumen of the lower renal tubules, many hemoglobin and myoglobin casts were found histologically, however, no severe congestion, as described previously, was seen in the kidney. Diffuse softning and bleeding of the brain was also confirmed. Electron microscopic studies of the lung revealed a number of virus-like particles in the extracellular space of alveoli or in the cytoplasm of the degenerated type I and II alveolar cells.They showed an irregular arrangement. Budding was rarely found. The size of the particles varied from 50mm to 300nm in diameter, encapsulated by a simple layer with microprocesses having many ribosome-like granules inside. The morphology of the particles resembled that of arenavirus. The similar particles were also constantly found in the exfoliated cells in the urine of the patients with hemorrhagic fever.Immunofluorescence and immunoperoxidase studies using the patient's serum or convalescent sera of other KHF patients revealed positive granular staining in the alveolar or bronchial epithelium. These results suggest that the etiologic agent might be the arenavirus-like particles in the exfoliated cells in urine and in the alveolar cells in the lung of the patient.
- 札幌医科大学の論文
- 1982-03-31
札幌医科大学 | 論文
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