title: Varicella Zoster Virus Infection in Granulomatous Arteritis of the Aorta.
abstract: Granulomatous arteritis characterizes the pathology of giant cell arteritis, granulomatous aortitis, and intracerebral varicella zoster virus (VZV) vasculopathy. Because intracerebral VZV vasculopathy and giant cell arteritis are strongly associated with productive VZV infection in cerebral and temporal arteries, respectively, we evaluated human aortas for VZV antigen and VZV DNA. Using 3 different anti-VZV antibodies, we identified VZV antigen in 11 of 11 aortas with pathologically verified granulomatous arteritis, in 1 of 1 cases of nongranulomatous arteritis, and in 5 of 18 control aortas (28%) obtained at autopsy. The presence of VZV antigen in granulomatous aortitis was highly significant (P = .0001) as compared to control aortas, in which VZV antigen was never associated with pathology, indicating subclinical reactivation. VZV DNA was found in most aortas containing VZV antigen. The frequent clinical, radiological, and pathological aortic involvement in patients with giant cell arteritis correlates with the significant detection of VZV in granulomatous aortitis.
authors.affiliation: Department of Neurology Department Immunology and Microbiology, University of Colorado School of Medicine, Aurora.
authors.forename: Don
authors.initials: D
authors.lastname: Gilden
authors.affiliation: Department of Neurology.
authors.forename: Teresa
authors.initials: T
authors.lastname: White
authors.affiliation: Department of Pathology, East Carolina University, Greenville, North Carolina.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Boyer
authors.affiliation: Department of Neurology, Brigham and Women's Hospital Department of Neurology.
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Galetta
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston.
authors.forename: E Tessa
authors.initials: ET
authors.lastname: Hedley-Whyte
authors.affiliation: Office of the Medical Examiner, Department of Environmental Health, Denver, Colorado.
authors.forename: Meredith
authors.initials: M
authors.lastname: Frank
authors.affiliation: Office of the Medical Examiner, Department of Environmental Health, Denver, Colorado.
authors.forename: Dawn
authors.initials: D
authors.lastname: Holmes
authors.affiliation: Department of Neurology.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Nagel
mesh_terms: D000914:Antibodies, Viral; D000956:Antigens, Viral / Q000032:analysis / Q000276:immunology; D001011:Aorta / Q000473:pathology*; D002644:Chickenpox; D006562:Herpes Zoster / Q000453:epidemiology*; D014645:Herpesvirus 3, Human / Q000276:immunology*; D006801:Humans; D007150:Immunohistochemistry; D013699:Temporal Arteries / Q000473:pathology; D020293:Vasculitis, Central Nervous System / Q000453:epidemiology* / Q000821:virology
chemical_list: D000914:Antibodies, Viral; D000956:Antigens, Viral
keywords: VZV; granulomatous aortitis; granulomatous arteritis