Reconsideration of histopathology and ultrastructural aspects of the human liver in yellow fever.
Yellow fever is a re-emerging infectious disease that currently is at risk of urbanization due to the advance of the Aedes aegypti vector. The disease affects about 200,000 individuals annually, mainly in tropical Africa and South America. It causes severe disease involving especially the liver, with lesions characterized by midzonal steatosis, apoptosis and lytic necrosis of the hepatocytes. Quantitative histological and immunohistochemical analysis of 53 human hepatic samples demonstrated apoptosis, steatosis and lytic necrosis of hepatocytes with midzonal pattern. No substantial alterations and reticular network were observed. The inflammatory infiltrate consisted of mononuclear cells and intensity was minimal or moderate, disproportionate to the intense death of the hepatocytes. Hepatic damage in yellow fever resulted mainly from a massive death of hepatocytes due to apoptosis and to a lesser extent due to lytic necrosis. It is recommended that therapeutic regimens for serious cases should include measures to protect against apoptosis.
Quaresma
Juarez Antonio Simões
JA
Tropical Medicine Unit, Department of Pathology, State University of Para, Belem, PA, Brazil. juarez@ufpa.br
Barros
Vera Lucia Reis Souza
VL
Fernandes
Elaine Rainero
ER
Pagliari
Carla
C
Takakura
Cleusa
C
da Costa Vasconcelos
Pedro Fernando
PF
de Andrade
Heitor Franco
HF
Duarte
Maria Irma Seixas
MI
D000293:Adolescent; D000328:Adult; D000368:Aged; D000956:Antigens, Viral / Q000032:analysis; D017209:Apoptosis; D002648:Child; D002675:Child, Preschool; D005234:Fatty Liver / Q000473:pathology / Q000821:virology; D005260:Female; D022781:Hepatocytes / Q000473:pathology / Q000648:ultrastructure / Q000821:virology; D006801:Humans; D007150:Immunohistochemistry; D008099:Liver / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D015004:Yellow Fever / Q000473:pathology* / Q000821:virology; D015005:Yellow fever virus / Q000254:growth & development*
D000956:Antigens, Viral