Skip to main content
Top
Published in: Virology Journal 1/2018

Open Access 01-12-2018 | Research

Multiple organ involvement in severe fever with thrombocytopenia syndrome: an immunohistochemical finding in a fatal case

Authors: Shibo Li, Yang Li, Qiujing Wang, Xuewen Yu, Miaomiao Liu, Haibo Xie, Liyong Qian, Ling Ye, Zhejuan Yang, Jianjing Zhang, Huimin Zhu, Wenhong Zhang

Published in: Virology Journal | Issue 1/2018

Login to get access

Abstracts

Background

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by SFTS bunyavirus (SFTSV), a tick borne bunyavirus. However, Immunohistochemistry of SFTS patients are not well studied.

Methods

We obtained multiple of tissues from a fatal case with SFTS, including blood, lungs, kidneys, heart, and spleen. The blood samples were used to isolate the causative agent for detection of viral RNA and further expression of recombinant viral protein as primary antibody. Immunohistochemistry of the heart, lungs, spleen and kidneys was used to characterize the viral antigen in tissue sections.

Results

A 79-year-old man, together with his wife, was admitted because of fever. Both patients were diagnosed with SFTS by the positive SFTSV RNA in the blood. The gentleman died of multiple organ failure 8 days after hospitalization. However, his wife recovered and was discharged. Immunohistochemistry indicated that SFTSV antigens were present in all studied organs including the heart, kidney, lung and spleen, of which the spleen presented with the highest amount of SFTSV antigens. The kidney was next while the heart and lungs showed lower amount of SFTSV antigens.

Conclusions

SFTSV can direct infect multiple organs, resulting in multiple organ failure and ultimately in an unfavorable outcome.
Appendix
Available only for authorised users
Literature
1.
go back to reference Takahashi T, Maeda K, Suzuki T, Ishido A, Shigeoka T, Tominaga T, Kamei T, Honda M, Ninomiya D, Sakai T, et al. The first identification and retrospective study of severe fever with thrombocytopenia syndrome in Japan. J Infect Dis. 2014;209(6):816–27.CrossRefPubMed Takahashi T, Maeda K, Suzuki T, Ishido A, Shigeoka T, Tominaga T, Kamei T, Honda M, Ninomiya D, Sakai T, et al. The first identification and retrospective study of severe fever with thrombocytopenia syndrome in Japan. J Infect Dis. 2014;209(6):816–27.CrossRefPubMed
2.
go back to reference Kim KH, Yi J, Kim G, Choi SJ, Jun KI, Kim NH, Choe PG, Kim NJ, Lee JK, Oh MD. Severe fever with thrombocytopenia syndrome, South Korea, 2012. Emerg Infect Dis. 2013;19(11):1892–4.CrossRefPubMedPubMedCentral Kim KH, Yi J, Kim G, Choi SJ, Jun KI, Kim NH, Choe PG, Kim NJ, Lee JK, Oh MD. Severe fever with thrombocytopenia syndrome, South Korea, 2012. Emerg Infect Dis. 2013;19(11):1892–4.CrossRefPubMedPubMedCentral
3.
go back to reference Yu XJ, Liang MF, Zhang SY, Liu Y, Li JD, Sun YL, Zhang L, Zhang QF, Popov VL, Li C, et al. Fever with thrombocytopenia associated with a novel bunyavirus in China. N Engl J Med. 2011;364(16):1523–32.CrossRefPubMedPubMedCentral Yu XJ, Liang MF, Zhang SY, Liu Y, Li JD, Sun YL, Zhang L, Zhang QF, Popov VL, Li C, et al. Fever with thrombocytopenia associated with a novel bunyavirus in China. N Engl J Med. 2011;364(16):1523–32.CrossRefPubMedPubMedCentral
4.
go back to reference Luo LM, Zhao L, Wen HL, Zhang ZT, Liu JW, Fang LZ, Xue ZF, Ma DQ, Zhang XS, Ding SJ, et al. Haemaphysalis longicornis ticks as reservoir and vector of severe fever with thrombocytopenia syndrome virus in China. Emerg Infect Dis. 2015;21(10):1770–6.CrossRefPubMedPubMedCentral Luo LM, Zhao L, Wen HL, Zhang ZT, Liu JW, Fang LZ, Xue ZF, Ma DQ, Zhang XS, Ding SJ, et al. Haemaphysalis longicornis ticks as reservoir and vector of severe fever with thrombocytopenia syndrome virus in China. Emerg Infect Dis. 2015;21(10):1770–6.CrossRefPubMedPubMedCentral
5.
go back to reference Liu Y, Li Q, Hu W, Wu J, Wang Y, Mei L, Walker DH, Ren J, Wang Y, Yu XJ. Person-to-person transmission of severe fever with thrombocytopenia syndrome virus. Vector Borne Zoonotic Dis. 2012;12(2):156–60.CrossRefPubMed Liu Y, Li Q, Hu W, Wu J, Wang Y, Mei L, Walker DH, Ren J, Wang Y, Yu XJ. Person-to-person transmission of severe fever with thrombocytopenia syndrome virus. Vector Borne Zoonotic Dis. 2012;12(2):156–60.CrossRefPubMed
6.
go back to reference Bao CJ, Guo XL, Qi X, Hu JL, Zhou MH, Varma JK, Cui LB, Yang HT, Jiao YJ, Klena JD, et al. A family cluster of infections by a newly recognized bunyavirus in eastern China, 2007: further evidence of person-to-person transmission. Clin Infect Dis. 2011;53(12):1208–14.CrossRefPubMed Bao CJ, Guo XL, Qi X, Hu JL, Zhou MH, Varma JK, Cui LB, Yang HT, Jiao YJ, Klena JD, et al. A family cluster of infections by a newly recognized bunyavirus in eastern China, 2007: further evidence of person-to-person transmission. Clin Infect Dis. 2011;53(12):1208–14.CrossRefPubMed
7.
go back to reference Gong Z, Gu S, Zhang Y, Sun J, Wu X, Ling F, Shi W, Zhang P, Li D, Mao H. Probable aerosol transmission of severe fever with thrombocytopenia syndrome virus in southeastern China. Clin Microbiol Infect. 2015;21(12):1115–20.CrossRefPubMed Gong Z, Gu S, Zhang Y, Sun J, Wu X, Ling F, Shi W, Zhang P, Li D, Mao H. Probable aerosol transmission of severe fever with thrombocytopenia syndrome virus in southeastern China. Clin Microbiol Infect. 2015;21(12):1115–20.CrossRefPubMed
8.
go back to reference Ding S, Niu G, Xu X, Li J, Zhang X, Yin H, Zhang N, Jiang X, Wang S, Liang M. Age is a critical risk factor for severe fever with thrombocytopenia syndrome. PLoS One. 2014;9(11):e111736.CrossRefPubMedPubMedCentral Ding S, Niu G, Xu X, Li J, Zhang X, Yin H, Zhang N, Jiang X, Wang S, Liang M. Age is a critical risk factor for severe fever with thrombocytopenia syndrome. PLoS One. 2014;9(11):e111736.CrossRefPubMedPubMedCentral
9.
go back to reference Jiang F, Wang L, Wang S, Zhu L, Dong L, Zhang Z, Hao B, Yang F, Liu W, Deng Y, et al. Meteorological factors affect the epidemiology of hemorrhagic fever with renal syndrome via altering the breeding and hantavirus-carrying states of rodents and mites: a 9 years’ longitudinal study. Emerg Microbes Infect. 2017;6(11):e104.CrossRefPubMedPubMedCentral Jiang F, Wang L, Wang S, Zhu L, Dong L, Zhang Z, Hao B, Yang F, Liu W, Deng Y, et al. Meteorological factors affect the epidemiology of hemorrhagic fever with renal syndrome via altering the breeding and hantavirus-carrying states of rodents and mites: a 9 years’ longitudinal study. Emerg Microbes Infect. 2017;6(11):e104.CrossRefPubMedPubMedCentral
10.
go back to reference Chen X, Ye H, Li S, Jiao B, Wu J, Zeng P, Chen L. Severe fever with thrombocytopenia syndrome virus inhibits exogenous type I IFN signaling pathway through its NSs in vitro. PLoS One. 2017;12(2):e0172744.CrossRefPubMedPubMedCentral Chen X, Ye H, Li S, Jiao B, Wu J, Zeng P, Chen L. Severe fever with thrombocytopenia syndrome virus inhibits exogenous type I IFN signaling pathway through its NSs in vitro. PLoS One. 2017;12(2):e0172744.CrossRefPubMedPubMedCentral
11.
go back to reference Ramos-Vara J, Miller M. When tissue antigens and antibodies get along: revisiting the technical aspects of immunohistochemistry—the red, brown, and blue technique. Vet Pathol. 2014;51(1):42–87.CrossRefPubMed Ramos-Vara J, Miller M. When tissue antigens and antibodies get along: revisiting the technical aspects of immunohistochemistry—the red, brown, and blue technique. Vet Pathol. 2014;51(1):42–87.CrossRefPubMed
12.
go back to reference M-m L, Lei X-Y, Yu X-j. Meta-analysis of the clinical and laboratory parameters of SFTS patients in China. Virol J. 2016;13(1):198.CrossRef M-m L, Lei X-Y, Yu X-j. Meta-analysis of the clinical and laboratory parameters of SFTS patients in China. Virol J. 2016;13(1):198.CrossRef
13.
go back to reference Gai ZT, Zhang Y, Liang MF, Jin C, Zhang S, Zhu CB, Li C, Li XY, Zhang QF, Bian PF, et al. Clinical progress and risk factors for death in severe fever with thrombocytopenia syndrome patients. J Infect Dis. 2012;206(7):1095–102.CrossRefPubMed Gai ZT, Zhang Y, Liang MF, Jin C, Zhang S, Zhu CB, Li C, Li XY, Zhang QF, Bian PF, et al. Clinical progress and risk factors for death in severe fever with thrombocytopenia syndrome patients. J Infect Dis. 2012;206(7):1095–102.CrossRefPubMed
14.
go back to reference Sun Y, Jin C, Zhan F, Wang X, Liang M, Zhang Q, Ding S, Guan X, Huo X, Li C, et al. Host cytokine storm is associated with disease severity of severe fever with thrombocytopenia syndrome. J Infect Dis. 2012;206(7):1085–94.CrossRefPubMed Sun Y, Jin C, Zhan F, Wang X, Liang M, Zhang Q, Ding S, Guan X, Huo X, Li C, et al. Host cytokine storm is associated with disease severity of severe fever with thrombocytopenia syndrome. J Infect Dis. 2012;206(7):1085–94.CrossRefPubMed
15.
go back to reference Hiraki T, Yoshimitsu M, Suzuki T, Goto Y, Higashi M, Yokoyama S, Tabuchi T, Futatsuki T, Nakamura K, Hasegawa H, et al. Two autopsy cases of severe fever with thrombocytopenia syndrome (SFTS) in Japan: a pathognomonic histological feature and unique complication of SFTS. Pathol Int. 2014;64(11):569–75.CrossRefPubMedPubMedCentral Hiraki T, Yoshimitsu M, Suzuki T, Goto Y, Higashi M, Yokoyama S, Tabuchi T, Futatsuki T, Nakamura K, Hasegawa H, et al. Two autopsy cases of severe fever with thrombocytopenia syndrome (SFTS) in Japan: a pathognomonic histological feature and unique complication of SFTS. Pathol Int. 2014;64(11):569–75.CrossRefPubMedPubMedCentral
16.
go back to reference Uehara N, Yano T, Ishihara A, Saijou M, Suzuki T. Fatal severe fever with thrombocytopenia syndrome: an autopsy case report. Intern Med. 2016;55(7):831–8.CrossRefPubMed Uehara N, Yano T, Ishihara A, Saijou M, Suzuki T. Fatal severe fever with thrombocytopenia syndrome: an autopsy case report. Intern Med. 2016;55(7):831–8.CrossRefPubMed
17.
go back to reference Liu Y, Wu B, Paessler S, Walker DH, Tesh RB, Yu XJ. The pathogenesis of severe fever with thrombocytopenia syndrome virus infection in alpha/beta interferon knockout mice: insights into the pathologic mechanisms of a new viral hemorrhagic fever. J Virol. 2014;88(3):1781–6.CrossRefPubMedPubMedCentral Liu Y, Wu B, Paessler S, Walker DH, Tesh RB, Yu XJ. The pathogenesis of severe fever with thrombocytopenia syndrome virus infection in alpha/beta interferon knockout mice: insights into the pathologic mechanisms of a new viral hemorrhagic fever. J Virol. 2014;88(3):1781–6.CrossRefPubMedPubMedCentral
Metadata
Title
Multiple organ involvement in severe fever with thrombocytopenia syndrome: an immunohistochemical finding in a fatal case
Authors
Shibo Li
Yang Li
Qiujing Wang
Xuewen Yu
Miaomiao Liu
Haibo Xie
Liyong Qian
Ling Ye
Zhejuan Yang
Jianjing Zhang
Huimin Zhu
Wenhong Zhang
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Virology Journal / Issue 1/2018
Electronic ISSN: 1743-422X
DOI
https://doi.org/10.1186/s12985-018-1006-7

Other articles of this Issue 1/2018

Virology Journal 1/2018 Go to the issue