Two autopsy cases of severe fever with thrombocytopenia syndrome (<scp>SFTS</scp>) in <scp>J</scp>apan: A pathognomonic histological feature and unique complication of <scp>SFTS</scp>

Hiraki, Takao; Yoshimitsu, Makoto; Suzuki, Tadaki; Goto, Yuko; Higashi, Michiyo; Yokoyama, Seiya; Tabuchi, Tomohisa; Futatsuki, Takahiro; Nakamura, Kentaro; Hasegawa, Hideki; Saijo, Masayuki; Kakihana, Yasuyuki; Arima, Naomichi; Yonezawa, Suguru

doi:10.1111/pin.12207

Cited by 83 publications

(104 citation statements)

References 16 publications

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“…Two of the patients with SFTS who died underwent autopsies and the pathological findings were reported (12). Although the novel findings in the report were fungal infections in the respiratory tract organs, there was no mention of whether the ulcerative lesions were present or not in the patients with SFTS, suggesting that ulcerative lesions were not observed in these patients.…”

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confidence: 51%

Ulcerative Lesions with Hemorrhage in a Patient with Severe Fever with Thrombocytopenia Syndrome Observed via Upper Gastrointestinal Endoscopy

Kaneyuki¹,

Yoshikawa

Tani

et al. 2016

Jpn J Infect Dis

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SUMMARY: Severe fever with thrombocytopenia syndrome (SFTS) is a novel bunyavirus infection caused by the SFTS virus (SFTSV, family Bunyaviridae, genus Phlebovirus) with a high case fatality rate. A previously healthy 72-year-old man showed symptoms of fever, general fatigue, and altered consciousness. He was hospitalized for treatment. On day 3, considering the day on which fever appeared first during the disease course as day 0, he had bloody emesis. An emergency upper gastrointestinal endoscopic examination revealed multiple ulcerative lesions with continuously oozing hemorrhage in the stomach. He died on day 7. He was retrospectively diagnosed as having SFTS, Although it was less likely that the gastric ulcerative lesions were directly induced by SFTSV replication, it was evident that hemorrhagic emesis might occur in the patient in association with the pathophysiology of SFTS. The real-time imaging of gastric ulcerative lesions in a patient with SFTS is reported.

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confidence: 51%

Ulcerative Lesions with Hemorrhage in a Patient with Severe Fever with Thrombocytopenia Syndrome Observed via Upper Gastrointestinal Endoscopy

Kaneyuki¹,

Yoshikawa

Tani

et al. 2016

Jpn J Infect Dis

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“…Virological and pathological examinations in Japanese patients with SFTS revealed that SFTS virus replicates in blastic cells in the local lymph nodes, but not in the major organs [3,12]. However, the kidney was not examined in these studies.…”

Section: Discussionmentioning

confidence: 95%

A Case of Severe Fever With Thrombocytopenia Syndrome Accompanied by Self-Limiting Severe Proteinuria That Inversely Correlated With the Platelet Count

et al. 2016

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We herein present a case of a 68-year-old man who was referred to our hospital for a tick bite accompanied by fever and general malaise. He exhibited typical clinical symptoms such as abdominal pain, diarrhea, and vomiting during hospitalization. A laboratory examination showed progressive thrombocytopenia and leukopenia during the early part of hospitalization. A definite diagnosis of severe fever with thrombocytopenia syndrome (SFTS) was made by a reverse transcription polymerase chain reaction (RT-PCR) from his blood sample in the Tokushima Prefectural Public Health Institute. Proteinuria is generally detected in more than half of patients with SFTS. In the present case, the clinical course showed a clear inverse correlation between self-limiting severe proteinuria and the platelet count during hospitalization. Although it is not currently clear how immunological interactions among the virus, platelets, and immunoglobulins affect the glomerulus or cause proteinuria, our results may contribute to elucidating the pathogenic mechanism of SFTS-associated glomerulonephritis. To the best of our knowledge, this case report is the first to show an inverse correlation between proteinuria and the platelet count in a patient with SFTS.

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“…Epidemiological study shows that 1.0%-3.8% of the examined population in hilly areas had SFTSV antibodies, which suggests that SFTSV has circulated widely in China, especially in rural areas [5]. SFTSV infection was also reported in other Asia countries such as Korea and Japan [6,7]. The mortality of SFTSV infection in China is about 2.5%-30% [8].…”

Section: Introductionmentioning

confidence: 93%

“…The disease occurs mainly in April and May during the peaking season in Henan [9]. One study indicated that SFTSV could cause the asymptomatic infections via person-to-person contact with infected blood [6]. At present; there is no specific medication to treat this disease.…”

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confidence: 99%

A Newly Discovered Severe Fever with Thrombocytopenia Syndrome Virus and its Mechanisms in Evading Host Innate Immunity

Chen¹

2015

J Antivir Antiretrovir

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IntroductionSFTSV is a newly discovered virus that was first reported in 2009 in China [1]. It was known as Huaiyangshan virus which is a new member of the Phlebovirus genus from the Bunyaviridae family [1]. Clinically, SFTSV can cause fever, gastrointestinal symptoms, myalgia, and regional lymphadenopathy [2]. The most significant manifestations of this disease are severe fever and thrombocytopenia [3]. The disease which could be transmitted through ticks has been found in many cities in China now, and the highest numbers of reported cases were in Henan (48% of the total), Hubei (22%), and Shangdong (16%) [4]. Epidemiological study shows that 1.0%-3.8% of the examined population in hilly areas had SFTSV antibodies, which suggests that SFTSV has circulated widely in China, especially in rural areas [5]. SFTSV infection was also reported in other Asia countries such as Korea and Japan [6,7]. The mortality of SFTSV infection in China is about 2.5%-30% [8]. Most patients are farmers who come from rural areas. Many of them have reported tick bites 7-9 days before getting illness. The disease occurs mainly in April and May during the peaking season in Henan [9]. One study indicated that SFTSV could cause the asymptomatic infections via person-to-person contact with infected blood [6]. At present; there is no specific medication to treat this disease. Patients are often treated with Ribavirin, a traditional nonspecific antiviral drug, but its efficacy remains uncertain [10].There is also report says that antibodies play an important role in curing the disease [11]. Neutralizing antibodies can reduce viral load, and prevent SFTSV spreading. A human monoclonal antibody, 4-5, has been shown to have neutralizing activity against SFTSV in vitro and it might be used for high risk people in the future [11]. For now, there is no effective vaccine to prevent SFTSV infection, so people living in rural areas should pay special attention to this virus, taking some preventive measures, for example protection against tick bites, avoidance of wooded and bushy areas where ticks are abundant, especially in April or May. Repellents, such as permethrin can also be applied [12,13]. SFTSV is susceptible to acid, heat, ether, sodium deoxycholate, other common disinfectants, and ultraviolet irradiation, and can be rapidly inactivated [14][15][16][17][18][19]. . M segment encodes the Gn and Gc which mediate SFTSV entry into human and animal cell lines [16]. Most recently, it has been shown that the lectin dendritic-cellspecific intercellular adhesion molecule 3-grabbing non-integrin (DC-SIGN) facilitates certain Phleboviruses entry into dendritic cells via Gn/Gc mediation, and over-expression of DC-SIGN was sufficient for SFTSV Gn/Gc-mediated entry into otherwise non-susceptible cells [22]. Glycoproteins encoded by M segment are also excellent targets for neutralizing antibodies [17]. Monocytic cells (THP-1), HEF, and cervical carcinoma (Hela) cells were resistant to SFTSV Gn/Gc mediated entry, which indicating that these cells may lack the ...

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Two autopsy cases of severe fever with thrombocytopenia syndrome (SFTS) in Japan: A pathognomonic histological feature and unique complication of SFTS

Cited by 83 publications

References 16 publications

Ulcerative Lesions with Hemorrhage in a Patient with Severe Fever with Thrombocytopenia Syndrome Observed via Upper Gastrointestinal Endoscopy

Ulcerative Lesions with Hemorrhage in a Patient with Severe Fever with Thrombocytopenia Syndrome Observed via Upper Gastrointestinal Endoscopy

A Case of Severe Fever With Thrombocytopenia Syndrome Accompanied by Self-Limiting Severe Proteinuria That Inversely Correlated With the Platelet Count

A Newly Discovered Severe Fever with Thrombocytopenia Syndrome Virus and its Mechanisms in Evading Host Innate Immunity

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