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Endotheliitis

About: Endotheliitis is a(n) research topic. Over the lifetime, 208 publication(s) have been published within this topic receiving 7328 citation(s). The topic is also known as: endotheliitis & endotheliumitis.

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Open accessJournal ArticleDOI: 10.1016/S0140-6736(20)30937-5
02 May 2020-The Lancet
Abstract: www.thelancet.com Vol 395 May 2, 202

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Topics: Endotheliitis (68%)

3,207 Citations


Open accessJournal ArticleDOI: 10.1016/S0140-6736(20)31305-2
01 Aug 2020-The Lancet
Abstract: Summary Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of an ongoing pandemic, with increasing deaths worldwide. To date, documentation of the histopathological features in fatal cases of the disease caused by SARS-CoV-2 (COVID-19) has been scarce due to sparse autopsy performance and incomplete organ sampling. We aimed to provide a clinicopathological report of severe COVID-19 cases by documenting histopathological changes and evidence of SARS-CoV-2 tissue tropism. Methods In this case series, patients with a positive antemortem or post-mortem SARS-CoV-2 result were considered eligible for enrolment. Post-mortem examinations were done on 14 people who died with COVID-19 at the King County Medical Examiner's Office (Seattle, WA, USA) and Snohomish County Medical Examiner's Office (Everett, WA, USA) in negative-pressure isolation suites during February and March, 2020. Clinical and laboratory data were reviewed. Tissue examination was done by light microscopy, immunohistochemistry, electron microscopy, and quantitative RT-PCR. Findings The median age of our cohort was 73·5 years (range 42–84; IQR 67·5–77·25). All patients had clinically significant comorbidities, the most common being hypertension, chronic kidney disease, obstructive sleep apnoea, and metabolic disease including diabetes and obesity. The major pulmonary finding was diffuse alveolar damage in the acute or organising phases, with five patients showing focal pulmonary microthrombi. Coronavirus-like particles were detected in the respiratory system, kidney, and gastrointestinal tract. Lymphocytic myocarditis was observed in one patient with viral RNA detected in the tissue. Interpretation The primary pathology observed in our cohort was diffuse alveolar damage, with virus located in the pneumocytes and tracheal epithelium. Microthrombi, where observed, were scarce and endotheliitis was not identified. Although other non-pulmonary organs showed susceptibility to infection, their contribution to the pathogenesis of SARS-CoV-2 infection requires further examination. Funding None.

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Topics: Diffuse alveolar damage (56%), Kidney disease (51%), Autopsy (51%) ...read more

382 Citations


Open accessJournal ArticleDOI: 10.1111/BJD.19327
Abstract: Background Chilblains ('COVID toes') are being seen with increasing frequency in children and young adults during the COVID-19 pandemic Detailed histopathological descriptions of COVID-19 chilblains have not been reported, and causality of SARS-CoV-2 has not yet been established Objectives To describe the histopathological features of COVID-19 chilblains and to explore the presence of SARS-CoV-2 in the tissue Methods We examined skin biopsies from seven paediatric patients presenting with chilblains during the COVID-19 pandemic Immunohistochemistry for SARS-CoV-2 was performed in all cases and electron microscopy in one Results Histopathology showed variable degrees of lymphocytic vasculitis ranging from endothelial swelling and endotheliitis to fibrinoid necrosis and thrombosis Purpura, superficial and deep perivascular lymphocytic inflammation with perieccrine accentuation, oedema, and mild vacuolar interface damage were also seen SARS-CoV-2 immunohistochemistry was positive in endothelial cells and epithelial cells of eccrine glands Coronavirus particles were found in the cytoplasm of endothelial cells on electron microscopy Conclusions Although the clinical and histopathological features were similar to other forms of chilblains, the presence of viral particles in the endothelium and the histological evidence of vascular damage support a causal relation of the lesions with SARS-CoV-2 Endothelial damage induced by the virus could be the key mechanism in the pathogenesis of COVID-19 chilblains and perhaps also in a group of patients severely affected by COVID-19 presenting with features of microangiopathic damage What is already known about this topic? Despite the high number of cases of chilblains seen during the COVID-19 pandemic, a definite causative role for SARS-CoV-2 has not yet been proven Different pathogenetic hypotheses have been proposed, including coagulation anomalies, interferon release and external factors What does this study add? The demonstration of SARS-CoV-2 in endothelial cells of skin biopsies by immunohistochemistry and electron microscopy confirms that these lesions are part of the spectrum of COVID-19 Virus-induced vascular damage and secondary ischaemia could explain the pathophysiology of COVID-19 chilblains Our findings support the hypothesis that widespread endothelial infection by SARS-CoV-2 could have a pathogenetic role in the severe forms of COVID-19 Linked Comment: Wetter Br J Dermatol 2020; 183:611

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Topics: Chilblains (73%), Fibrinoid necrosis (51%), Endotheliitis (50%)

235 Citations


Open accessJournal ArticleDOI: 10.1186/S13054-020-03062-7
16 Jun 2020-Critical Care
Abstract: In severe SARS-CoV-2 infections, emerging data including recent histopathological studies have emphasized the crucial role of endothelial cells (ECs) in vascular dysfunction, immunothrombosis, and inflammation.Histopathological studies have evidenced direct viral infection of ECs, endotheliitis with diffuse endothelial inflammation, and micro- and macrovascular thrombosis both in the venous and arterial circulations. Venous thrombotic events, particularly pulmonary embolism, with elevated D-dimer and coagulation activation are highly prevalent in COVID-19 patients. The pro-inflammatory cytokine storm, with elevated levels of interleukin-6 (IL-6), IL-2 receptor, and tumor necrosis factor-α, could also participate in endothelial dysfunction and leukocyte recruitment in the microvasculature. COVID-19-induced endotheliitis may explain the systemic impaired microcirculatory function in different organs in COVID-19 patients. Ongoing trials directly and indirectly target COVID-19-related endothelial dysfunctions: i.e., a virus-cell entry using recombinant angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS-2) blockade, coagulation activation, and immunomodulatory therapies, such as anti-IL-6 strategies. Studies focusing on endothelial dysfunction in COVID-19 patients are warranted as to decipher their precise role in severe SARS-CoV-2 infection and organ dysfunction and to identify targets for further interventions.

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Topics: Endothelial dysfunction (60%), Organ dysfunction (57%), Endotheliitis (53%) ...read more

212 Citations


Journal ArticleDOI: 10.1097/00003226-199903000-00002
Edward J. Holland1, Gary S. SchwartzInstitutions (1)
01 Mar 1999-Cornea
Abstract: PURPOSE We propose a nomenclature for classification of herpes simplex virus (HSV) keratitis. We hope that a more consistent classification system will lead to a better understanding of the disease processes, thus resulting in improved diagnosis, treatment, and patient outcomes. METHODS A review of the literature was performed to evaluate current HSV classification systems. These systems were evaluated in the context of both current clinical and basic science studies and our own clinical observations. RESULTS The proposed classification system is based on the anatomy and pathophysiology of the specific presentations of HSV keratitis. Anatomically, the primary level of corneal involvement, whether epithelium, stroma, or endothelium, must be elucidated. Pathophysiologically, the cause of the inflammation. whether immunologic, infectious, or neurotrophic, must be determined. There are four major categories of HSV keratitis. (1) Infectious epithelial keratitis, which is made up of cornea vesicles, dendritic ulcer, geographic ulcer, and marginal ulcer. (2) Neurotrophic keratopathy, which includes punctate epithelial erosions and neurotrophic ulcer. (3) Stromal keratitis, which is subdivided into necrotizing stromal keratitis and immune stromal keratitis. (4) Endotheliitis, which has three clinical presentations: disciform, diffuse, and linear. CONCLUSION We believe that by categorizing cases of HSV keratitis by their primary anatomic and pathophysiologic etiologic characteristics, clinicians can better understand and therefore treat all types of HSV keratitis. The four main categories of HSV keratitis are infectious epithelial keratitis, neurotrophic keratopathy, stromal keratitis, and endotheliitis. Each of these is subdivided to more specific clinical presentations.

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Topics: Keratitis (62%), Punctate epithelial erosions (53%), Endotheliitis (52%)

166 Citations


Performance
Metrics
No. of papers in the topic in previous years
YearPapers
202140
202028
201910
20188
201710
20169

Top Attributes

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Topic's top 5 most impactful authors

Tsutomu Inatomi

5 papers, 364 citations

Donald T.H. Tan

5 papers, 200 citations

Shigeru Kinoshita

5 papers, 224 citations

Vishal Jhanji

4 papers, 20 citations

Tomoyuki Inoue

4 papers, 73 citations

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