Document Detail

Autopsy findings in eight patients with fatal H1N1 influenza.
MedLine Citation:
PMID:  20551263     Owner:  NLM     Status:  MEDLINE    
A novel H1N1 influenza A virus emerged in April 2009, and rapidly reached pandemic proportions. We report a retrospective observational case study of pathologic findings in 8 patients with fatal novel H1N1 infection at the University of Michigan Health Systems (Ann Arbor) compared with 8 age-, sex-, body mass index-, and treatment-matched control subjects. Diffuse alveolar damage (DAD) in acute and organizing phases affected all patients with influenza and was accompanied by acute bronchopneumonia in 6 patients. Organizing DAD with established fibrosis was present in 1 patient with preexisting granulomatous lung disease. Only 50% of control subjects had DAD. Peripheral pulmonary vascular thrombosis occurred in 5 of 8 patients with influenza and 3 of 8 control subjects. Cytophagocytosis was seen in all influenza-related cases. The autopsy findings in our patients with novel H1N1 influenza resemble other influenza virus infections with the exception of prominent thrombosis and hemophagocytosis. The possibility of hemophagocytic syndrome should be investigated in severely ill patients with H1N1 infection.
Paul W Harms; Lindsay A Schmidt; Lauren B Smith; Duane W Newton; Maria A Pletneva; Laura L Walters; Scott A Tomlins; Amanda Fisher-Hubbard; Lena M Napolitano; Pauline K Park; Mila Blaivas; Joseph Fantone; Jeffrey L Myers; Jeffrey M Jentzen
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  American journal of clinical pathology     Volume:  134     ISSN:  1943-7722     ISO Abbreviation:  Am. J. Clin. Pathol.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-16     Completed Date:  2010-07-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370470     Medline TA:  Am J Clin Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  27-35     Citation Subset:  AIM; IM    
Dept of Pathology, University of Michigan, Ann Arbor, 48109-5602, USA.
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MeSH Terms
Bronchopneumonia / pathology,  virology
DNA, Viral / analysis
Fatal Outcome
Influenza A Virus, H1N1 Subtype / genetics,  isolation & purification*
Influenza, Human / pathology*,  virology
Lung / pathology*,  virology
Lymphohistiocytosis, Hemophagocytic / pathology,  virology
Middle Aged
Pulmonary Alveoli / pathology,  virology
Pulmonary Embolism / pathology,  virology
Retrospective Studies
Young Adult
Reg. No./Substance:
0/DNA, Viral

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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