title: Multiple organ failure syndrome in the newborn: morphological and immunohistochemical data.
abstract: Multiple organ failure (MOF) syndrome, also known as multiple organ dysfunction syndrome (MODS) represents a common but complex problem in critically ill patients in neonatal intensive care unit (NICU) centers, and a major cause of morbidity and mortality in newborns. MOF is considered the result of an inappropriate generalized inflammatory response of the newborn to a variety of acute insults. This study was aimed at analyzing, at histology, multiple organ pathological changes in two newborns admitted to the NICU center of our University Hospital, who showed a progressive clinical picture of MOF, in order to verify the pathological changes of vascular structures and of endothelial cells in the different organs affected by MOF. All the samples obtained at autopsy for histological examination showed specific organ pathological changes, especially related to modifications in vascular structures and, in particular, in endothelial cells. The most interesting findings were found in the intestinal barrier, in the lower respiratory tract and in the endothelial barrier. The loss of the gut barrier could allow the passage into the blood of microbial factors that could trigger the production of tumor necrosis factor α (TNFα) leading to endothelial damage. Our preliminary study underlines the principal role probably played by intestinal and vascular changes in the origin of MOF in newborns.
authors.affiliation: Department of Pathology, University of Cagliari, Cagliari, Italy. gavinofaa@gmail.com
authors.forename: Gavino
authors.initials: G
authors.lastname: Faa
authors.forename: Daniela
authors.initials: D
authors.lastname: Fanni
authors.forename: Clara
authors.initials: C
authors.lastname: Gerosa
authors.forename: Sonia
authors.initials: S
authors.lastname: Nemolato
authors.forename: Armando
authors.initials: A
authors.lastname: Faa
authors.forename: Eleonora
authors.initials: E
authors.lastname: Obinu
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Puxeddu
authors.forename: Matteo
authors.initials: M
authors.lastname: Fraschini
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Iacovidou
authors.forename: Marco
authors.initials: M
authors.lastname: Zaffanello
authors.forename: Vassilios
authors.initials: V
authors.lastname: Fanos
mesh_terms: D001808:Blood Vessels / Q000473:pathology; D016207:Cytokines / Q000378:metabolism; D042783:Endothelial Cells / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D007422:Intestines / Q000098:blood supply / Q000473:pathology; D009102:Multiple Organ Failure / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology*; D012137:Respiratory System / Q000098:blood supply / Q000473:pathology
chemical_list: D016207:Cytokines