Journal
PATHOLOGY RESEARCH AND PRACTICE
Volume 213, Issue 9, Pages 1144-1151Publisher
ELSEVIER GMBH
DOI: 10.1016/j.prp.2017.07.004
Keywords
Hand Foot and mouth disease (HFMD); EV71; Autopsy; Immunohistochemistry; SCARB2; PSGL-1
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Funding
- Funds of Guangxi Provincial Health Bureau Scientific Research Project [Z2014647]
- Guangxi Provincial Health Bureau Key Scientific Research Project [2011097]
- Guangxi Natural Science Foundation of China [2013GXNSFAA019157]
- Guangxi Medical University Future Academic Stars [2016WLXSZX17037]
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Objective: To investigate the pathological features of fatal pediatric hand foot and mouth disease (HFMD). Methods: The histopathological features of HFMD were first summarized from literature, and then confirmed by in-house autopsies. Furthermore, immunohistochemistry was conducted to detect the distribution and expression level of two enterovirus 71 (EV71) receptors scavenger receptor class B, member 2 (SCARB2), and P-selectin glycoprotein ligand-1 (PSGL1) in the samples of autopsies. Results: The main symptoms of HFMD included hand and foot rashes, as well as oral herpes. The fatal HFMD patients had typical histopathological change in the central nervous system, such as encephaledema and encephalitis. As for respiratory system, the fatal HFMD patients suffered acute pulmonary edema and congestion. SCARB2 positive signaling was distributed equally in bronchial and bronchiolar epithelial cells, alveolar epithelial cells and inflammatory cells of all HFMD patients, healthy children and adults without significant difference. PSGL-1 dispersed in bronchial and bronchiolar epithelial cells of healthy adults, but no PSGL-1 expression was detected in HFMD patients and healthy children. Conclusions: Both of the central nervous and respiratory systems may be involved in the fatal HFMD patients. The EV71 receptor PSGL-1 might play essential parts in the pathogenesis of fatal HFMD, however, the hypothesis needs to be further investigated. (C) 2017 Elsevier GmbH. All rights reserved.
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