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  1. Article ; Online: The case of the eyelid silicone granulomas.

    Wulu, Jacqueline A / Garcia-Rodriguez, Laura / Prilutskiy, Andrey / Spiegel, Jeffrey H

    American journal of otolaryngology

    2019  Volume 40, Issue 5, Page(s) 776–778

    Abstract: Foreign body granulomas can develop even several years after autologous fat or filler injection. In some instances the foreign body granulomas have been found at sites other than the original injection site. We present a case of a 48-year-old male with ... ...

    Abstract Foreign body granulomas can develop even several years after autologous fat or filler injection. In some instances the foreign body granulomas have been found at sites other than the original injection site. We present a case of a 48-year-old male with reported "hyaluronic acid fillers" injected into his upper and lower eyelids several years prior. He subsequently developed periorbital swelling with negative allergic and rheumatologic workup. The patient ultimately underwent a blepharoplasty for improvement of the swelling. Histopathology suggested silicone granulomas of the upper and lower eyelid. This case illustrates the importance of keeping foreign body granulomas on the differential for all patients with a history of facial dermal filler injections. Although hyaluronic acid is the most common dermal filler, providers should suspect the use of other dermal fillers including those not FDA approved particularly when common conservative treatment methods are not sufficient.
    MeSH term(s) Biopsy, Needle ; Blepharoplasty/adverse effects ; Blepharoplasty/methods ; Dermal Fillers/adverse effects ; Follow-Up Studies ; Granuloma, Foreign-Body/etiology ; Granuloma, Foreign-Body/pathology ; Granuloma, Foreign-Body/surgery ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Risk Assessment ; Silicones/adverse effects ; Treatment Outcome
    Chemical Substances Dermal Fillers ; Silicones
    Language English
    Publishing date 2019-05-14
    Publishing country United States
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 604541-8
    ISSN 1532-818X ; 0196-0709
    ISSN (online) 1532-818X
    ISSN 0196-0709
    DOI 10.1016/j.amjoto.2019.05.010
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Solitary intramuscular myofibroma in an adult: Case report and MR imaging findings.

    Santo, Irene Dixe de Oliveira / Staziaki, Pedro V / Prilutskiy, Andrey / Sachs, Teviah E / Murakami, Akira M

    Clinical imaging

    2020  Volume 67, Page(s) 95–100

    Abstract: Myofibroma is a benign, soft tissue neoplasm that predominantly affects infants and young children. Most occur in the skin or subcutaneous tissues, with a predilection for the head and neck regions. We describe the magnetic resonance (MR) imaging and ... ...

    Abstract Myofibroma is a benign, soft tissue neoplasm that predominantly affects infants and young children. Most occur in the skin or subcutaneous tissues, with a predilection for the head and neck regions. We describe the magnetic resonance (MR) imaging and histophathologic findings of a rare case of intramuscular myofibroma of the right deltoid in a healthy 30-year-old male. MR imaging revealed a well-circumscribed intramuscular mass, with isointense signal on T1-weighted images, hyperintense signal on T2-weighed images, and a "target-sign" with peripheral rim enhancement after gadolinium administration. The lesion was surgically excised with no complications, and the histopathologic analysis revealed the typical morphologic and histochemical markers of a myofibroma. We conclude that, although rare, myofibroma can be considered in the differential diagnosis of adults with lesions the above signal characteristics.
    MeSH term(s) Adult ; Diagnosis, Differential ; Gadolinium ; Head/pathology ; Humans ; Leiomyoma ; Magnetic Resonance Imaging ; Male ; Myofibroma/diagnostic imaging ; Myofibroma/pathology ; Myofibromatosis ; Neck/pathology ; Soft Tissue Neoplasms
    Chemical Substances Gadolinium (AU0V1LM3JT)
    Language English
    Publishing date 2020-05-30
    Publishing country United States
    Document type Case Reports
    ZDB-ID 1028123-x
    ISSN 1873-4499 ; 0899-7071
    ISSN (online) 1873-4499
    ISSN 0899-7071
    DOI 10.1016/j.clinimag.2020.05.027
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: First Clinical Results of Fluorescence Lifetime-enhanced Tumor Imaging Using Receptor-targeted Fluorescent Probes.

    Pal, Rahul / Hom, Marisa E / van den Berg, Nynke S / Lwin, Thinzar M / Lee, Yu-Jin / Prilutskiy, Andrey / Faquin, William / Yang, Eric / Saladi, Srinivas V / Varvares, Mark A / Rosenthal, Eben L / Kumar, Anand T N

    Clinical cancer research : an official journal of the American Association for Cancer Research

    2022  Volume 28, Issue 11, Page(s) 2373–2384

    Abstract: Purpose: Fluorescence molecular imaging, using cancer-targeted near infrared (NIR) fluorescent probes, offers the promise of accurate tumor delineation during surgeries and the detection of cancer specific molecular expression in vivo. However, ... ...

    Abstract Purpose: Fluorescence molecular imaging, using cancer-targeted near infrared (NIR) fluorescent probes, offers the promise of accurate tumor delineation during surgeries and the detection of cancer specific molecular expression in vivo. However, nonspecific probe accumulation in normal tissue results in poor tumor fluorescence contrast, precluding widespread clinical adoption of novel imaging agents. Here we present the first clinical evidence that fluorescence lifetime (FLT) imaging can provide tumor specificity at the cellular level in patients systemically injected with panitumumab-IRDye800CW, an EGFR-targeted NIR fluorescent probe.
    Experimental design: We performed wide-field and microscopic FLT imaging of resection specimens from patients injected with panitumumab-IRDye800CW under an FDA directed clinical trial.
    Results: We show that the FLT within EGFR-overexpressing cancer cells is significantly longer than the FLT of normal tissue, providing high sensitivity (>98%) and specificity (>98%) for tumor versus normal tissue classification, despite the presence of significant nonspecific probe accumulation. We further show microscopic evidence that the mean tissue FLT is spatially correlated (r > 0.85) with tumor-specific EGFR expression in tissue and is consistent across multiple patients. These tumor cell-specific FLT changes can be detected through thick biological tissue, allowing highly specific tumor detection and noninvasive monitoring of tumor EFGR expression in vivo.
    Conclusions: Our data indicate that FLT imaging is a promising approach for enhancing tumor contrast using an antibody-targeted NIR probe with a proven safety profile in humans, suggesting a strong potential for clinical applications in image guided surgery, cancer diagnostics, and staging.
    MeSH term(s) Cell Line, Tumor ; ErbB Receptors/genetics ; ErbB Receptors/metabolism ; Fluorescence ; Fluorescent Dyes/metabolism ; Humans ; Neoplasms/diagnostic imaging ; Neoplasms/metabolism ; Optical Imaging/methods ; Panitumumab
    Chemical Substances Fluorescent Dyes ; Panitumumab (6A901E312A) ; ErbB Receptors (EC 2.7.10.1)
    Language English
    Publishing date 2022-03-17
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 1225457-5
    ISSN 1557-3265 ; 1078-0432
    ISSN (online) 1557-3265
    ISSN 1078-0432
    DOI 10.1158/1078-0432.CCR-21-3429
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Acute promyelocytic leukaemia presenting as necrotising fasciitis of the perineum (Fournier gangrene).

    Furtado, Vanessa Fiorini / Batalini, Felipe / Staziaki, Pedro V / Prilutskiy, Andrey / Sloan, John Mark

    BMJ case reports

    2018  Volume 11, Issue 1

    Abstract: We present a case of an unusual presentation of acute promyelocytic leukaemia (APML), which presented with Fournier gangrene (FG). A 38-year-old man presented with malaise, groin swelling, anal bleeding, fever and was found to have FG. Initial workup ... ...

    Abstract We present a case of an unusual presentation of acute promyelocytic leukaemia (APML), which presented with Fournier gangrene (FG). A 38-year-old man presented with malaise, groin swelling, anal bleeding, fever and was found to have FG. Initial workup revealed pancytopaenia, borderline low fibrinogen, prolonged international normalized ratio (INR), which raised the suspicion for leukaemia. The peripheral blood differential revealed leucopaenia with absolute neutropaenia and a 5% abnormal promyelocytes but no blasts, suspicious for APML. Bone marrow biopsy was performed and fluorescence in situ hydridization (FISH), karyotype and PCR confirmed a t(15;17) translocation, establishing a diagnosis of APML. After 1 month of therapy for intermediate risk APML with All-trans retinoic acid (ATRA) and arsenic trioxide (ATO), repeat chromosomal analysis and repeat bone marrow biopsy revealed no evidence of residual APML. After the consolidation phase was started with ATRA and ATO regimen, the wound healed after 2 months and the patient achieved complete remission.
    MeSH term(s) Adult ; Anti-Bacterial Agents/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Arsenic Trioxide/therapeutic use ; Fasciitis, Necrotizing/drug therapy ; Fasciitis, Necrotizing/etiology ; Fasciitis, Necrotizing/microbiology ; Fournier Gangrene/drug therapy ; Fournier Gangrene/etiology ; Fournier Gangrene/microbiology ; Humans ; Leukemia, Promyelocytic, Acute/diagnosis ; Leukemia, Promyelocytic, Acute/drug therapy ; Leukemia, Promyelocytic, Acute/microbiology ; Leukemia, Promyelocytic, Acute/pathology ; Male ; Perineum/pathology ; Remission Induction ; Treatment Outcome ; Tretinoin/therapeutic use
    Chemical Substances Anti-Bacterial Agents ; Tretinoin (5688UTC01R) ; Arsenic Trioxide (S7V92P67HO)
    Language English
    Publishing date 2018-12-07
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2018-226837
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Distinctive pseudopalisaded histiocytic hyperplasia characterizes the transition of exudative to proliferative phase of diffuse alveolar damage in patients dying of COVID-19.

    Kritselis, Michael / Yambayev, Ilyas / Prilutskiy, Andrey / Shevtsov, Artem / Vadlamudi, Charitha / Zheng, Hanqiao / Elsadwai, Murad / Ma, Lina / Aniskovich, Emily / Kataria, Yachana / Higgins, Sara / Sarita-Reyes, Carmen / Zuo, Tao / Zhao, Qing / Quillen, Karen / Burks, Eric J

    Human pathology

    2021  Volume 116, Page(s) 49–62

    Abstract: Severe COVID-19 results in a glucocorticoid responsive form of acute respiratory distress (ARDS)/diffuse alveolar damage (DAD). Herein we compare the immunopathology of lung tissue procured at autopsy in patients dying of SARS-CoV-2 with those dying of ... ...

    Abstract Severe COVID-19 results in a glucocorticoid responsive form of acute respiratory distress (ARDS)/diffuse alveolar damage (DAD). Herein we compare the immunopathology of lung tissue procured at autopsy in patients dying of SARS-CoV-2 with those dying of DAD prior to the COVID-19 pandemic. Autopsy gross and microscopic features stratified by duration of illness in twelve patients who tested positive for SARS-CoV-2 viral RNA, as well as seven patients dying of DAD prior to the COVID-19 pandemic were evaluated with multiplex (5-plex: CD4, CD8, CD68, CD20, AE1/AE3) and SARS-CoV immunohistochemistry to characterize the immunopathologic stages of DAD. We observed a distinctive pseudopalisaded histiocytic hyperplasia interposed between the exudative and proliferative phase of COVID-19 associated DAD, which was most pronounced at the fourth week from symptom onset. Pulmonary macrothrombi were seen predominantly in cases with pseudopalisaded histiocytic hyperplasia and/or proliferative phase DAD. Neither pseudopalisaded histiocytic hyperplasia nor pulmonary macrothrombi was seen in non-COVID-19 DAD cases, whereas microthrombi were common in DAD regardless of etiology. The inflammatory pattern of pseudopalisaded histiocytic hyperplasia may represent the distinctive immunopathology associated with the dexamethasone responsive form of DAD seen in severe COVID-19.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; COVID-19/pathology ; Cell Proliferation/physiology ; Female ; Histiocytes/pathology ; Humans ; Hyperplasia/pathology ; Lung/pathology ; Male ; Middle Aged ; Pulmonary Alveoli/pathology
    Language English
    Publishing date 2021-07-14
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 207657-3
    ISSN 1532-8392 ; 0046-8177
    ISSN (online) 1532-8392
    ISSN 0046-8177
    DOI 10.1016/j.humpath.2021.06.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Fluorescence lifetime of injected indocyanine green as a universal marker of solid tumours in patients.

    Pal, Rahul / Lwin, Thinzar M / Krishnamoorthy, Murali / Collins, Hannah R / Chan, Corey D / Prilutskiy, Andrey / Nasrallah, MacLean P / Dijkhuis, Tom H / Shukla, Shriya / Kendall, Amy L / Marshall, Michael S / Carp, Stefan A / Hung, Yin P / Shih, Angela R / Martinez-Lage, Maria / Zukerberg, Lawrence / Sadow, Peter M / Faquin, William C / Nahed, Brian V /
    Feng, Allen L / Emerick, Kevin S / Mieog, J Sven D / Vahrmeijer, Alexander L / Rajasekaran, Karthik / Lee, John Y K / Rankin, Kenneth S / Lozano-Calderon, Santiago / Varvares, Mark A / Tanabe, Kenneth K / Kumar, Anand T N

    Nature biomedical engineering

    2023  Volume 7, Issue 12, Page(s) 1649–1666

    Abstract: The surgical resection of solid tumours can be enhanced by fluorescence-guided imaging. However, variable tumour uptake and incomplete clearance of fluorescent dyes reduces the accuracy of distinguishing tumour from normal tissue via conventional ... ...

    Abstract The surgical resection of solid tumours can be enhanced by fluorescence-guided imaging. However, variable tumour uptake and incomplete clearance of fluorescent dyes reduces the accuracy of distinguishing tumour from normal tissue via conventional fluorescence intensity-based imaging. Here we show that, after systemic injection of the near-infrared dye indocyanine green in patients with various types of solid tumour, the fluorescence lifetime (FLT) of tumour tissue is longer than the FLT of non-cancerous tissue. This tumour-specific shift in FLT can be used to distinguish tumours from normal tissue with an accuracy of over 97% across tumour types, and can be visualized at the cellular level using microscopy and in larger specimens through wide-field imaging. Unlike fluorescence intensity, which depends on imaging-system parameters, tissue depth and the amount of dye taken up by tumours, FLT is a photophysical property that is largely independent of these factors. FLT imaging with indocyanine green may improve the accuracy of cancer surgeries.
    MeSH term(s) Humans ; Indocyanine Green ; Fluorescence ; Neoplasms/diagnostic imaging ; Fluorescent Dyes
    Chemical Substances Indocyanine Green (IX6J1063HV) ; Fluorescent Dyes
    Language English
    Publishing date 2023-10-16
    Publishing country England
    Document type Journal Article
    ISSN 2157-846X
    ISSN (online) 2157-846X
    DOI 10.1038/s41551-023-01105-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: SARS-CoV-2 Infection-Associated Hemophagocytic Lymphohistiocytosis.

    Prilutskiy, Andrey / Kritselis, Michael / Shevtsov, Artem / Yambayev, Ilyas / Vadlamudi, Charitha / Zhao, Qing / Kataria, Yachana / Sarosiek, Shayna R / Lerner, Adam / Sloan, J Mark / Quillen, Karen / Burks, Eric J

    American journal of clinical pathology

    2020  Volume 154, Issue 4, Page(s) 466–474

    Abstract: Objectives: A subset of coronavirus disease 2019 (COVID-19) patients exhibit clinical features of cytokine storm. However, clinicopathologic features diagnostic of hemophagocytic lymphohistiocytosis (HLH) have not been reported. We studied the ... ...

    Abstract Objectives: A subset of coronavirus disease 2019 (COVID-19) patients exhibit clinical features of cytokine storm. However, clinicopathologic features diagnostic of hemophagocytic lymphohistiocytosis (HLH) have not been reported. We studied the reticuloendothelial organs of 4 consecutive patients who died of COVID-19 and correlated with clinical and laboratory parameters to detect HLH.
    Methods: Autopsies were performed on 4 patients who died of COVID-19. Routine H&E staining and immunohistochemical staining for CD163 were performed to detect hemophagocytosis. Clinical and laboratory results from premortem blood samples were used to calculate H-scores.
    Results: All 4 cases demonstrated diffuse alveolar damage within the lungs. Three of the 4 cases had histologic evidence of hemophagocytosis within pulmonary lymph nodes. One case showed hemophagocytosis in the spleen but none showed hemophagocytosis in liver or bone marrow. Lymphophagocytosis was the predominant form of hemophagocytosis observed. One patient showed diagnostic features of HLH with an H-score of 217, while a second patient likely had HLH with a partial H-score of 145 due to a missing triglyceride level. The remaining 2 patients had H-scores of 131 and 96.
    Conclusions: This is the first report of severe acute respiratory syndrome coronavirus 2-associated HLH. Identification of HLH in a subset of patients with severe COVID-19 will inform clinical trials of therapeutic strategies.
    MeSH term(s) Aged ; Aged, 80 and over ; Autopsy ; Betacoronavirus ; Bone Marrow/pathology ; COVID-19 ; Coronavirus Infections/complications ; Coronavirus Infections/diagnosis ; Coronavirus Infections/pathology ; Fatal Outcome ; Female ; Humans ; Liver/pathology ; Lung/pathology ; Lymph Nodes/pathology ; Lymphohistiocytosis, Hemophagocytic/diagnosis ; Lymphohistiocytosis, Hemophagocytic/pathology ; Lymphohistiocytosis, Hemophagocytic/virology ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/pathology ; SARS-CoV-2 ; Spleen/pathology
    Keywords covid19
    Language English
    Publishing date 2020-07-17
    Publishing country England
    Document type Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2944-0
    ISSN 1943-7722 ; 0002-9173
    ISSN (online) 1943-7722
    ISSN 0002-9173
    DOI 10.1093/ajcp/aqaa124
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: SARS-CoV-2 Infection-Associated Hemophagocytic Lymphohistiocytosis

    Prilutskiy, Andrey / Kritselis, Michael / Shevtsov, Artem / Yambayev, Ilyas / Vadlamudi, Charitha / Zhao, Qing / Kataria, Yachana / Sarosiek, Shayna R / Lerner, Adam / Sloan, J Mark / Quillen, Karen / Burks, Eric J

    Am J Clin Pathol

    Abstract: OBJECTIVES: A subset of coronavirus disease 2019 (COVID-19) patients exhibit clinical features of cytokine storm. However, clinicopathologic features diagnostic of hemophagocytic lymphohistiocytosis (HLH) have not been reported. We studied the ... ...

    Abstract OBJECTIVES: A subset of coronavirus disease 2019 (COVID-19) patients exhibit clinical features of cytokine storm. However, clinicopathologic features diagnostic of hemophagocytic lymphohistiocytosis (HLH) have not been reported. We studied the reticuloendothelial organs of 4 consecutive patients who died of COVID-19 and correlated with clinical and laboratory parameters to detect HLH. METHODS: Autopsies were performed on 4 patients who died of COVID-19. Routine H&E staining and immunohistochemical staining for CD163 were performed to detect hemophagocytosis. Clinical and laboratory results from premortem blood samples were used to calculate H-scores. RESULTS: All 4 cases demonstrated diffuse alveolar damage within the lungs. Three of the 4 cases had histologic evidence of hemophagocytosis within pulmonary lymph nodes. One case showed hemophagocytosis in the spleen but none showed hemophagocytosis in liver or bone marrow. Lymphophagocytosis was the predominant form of hemophagocytosis observed. One patient showed diagnostic features of HLH with an H-score of 217, while a second patient likely had HLH with a partial H-score of 145 due to a missing triglyceride level. The remaining 2 patients had H-scores of 131 and 96. CONCLUSIONS: This is the first report of severe acute respiratory syndrome coronavirus 2-associated HLH. Identification of HLH in a subset of patients with severe COVID-19 will inform clinical trials of therapeutic strategies.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #654222
    Database COVID19

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  9. Article ; Online: SARS-CoV-2 Infection Associated Hemophagocytic Lymphohistiocytosis: An autopsy series with clinical and laboratory correlation.

    Prilutskiy, Andrey / Kritselis, Michael / Shevtsov, Artem / Yambayev, Ilyas / Vadlamudi, Charitha / Zhao, Qing / Kataria, Yachana / Sarosiek, Shayna / Lerner, Adam / Sloan, John Mark / Quillen, Karen / Burks, Eric

    medRxiv

    Abstract: Background: A subset of COVID-19 patients exhibit clinical features of cytokine storm. However, clinicopathologic features diagnostic of hemophagocytic lymphohistiocytosis (HLH) have not been reported. Pathologic studies to date have largely focused on ... ...

    Abstract Background: A subset of COVID-19 patients exhibit clinical features of cytokine storm. However, clinicopathologic features diagnostic of hemophagocytic lymphohistiocytosis (HLH) have not been reported. Pathologic studies to date have largely focused on the pulmonary finding of diffuse alveolar damage (DAD). To this aim, we study the reticuloendothelial organs of four consecutive patients dying of COVID-19 and correlate with clinical and laboratory parameters to detect HLH. Methods: Autopsies restricted to chest and abdomen were performed on four patients who succumbed to COVID-19. Spleen, liver, and multiple pulmonary hilar/mediastinal lymph nodes were sampled in all cases. Bone marrow was obtained by rib squeeze in a subset of cases. Routine H&E staining as well as immunohistochemical staining for CD163 was performed to detect hemophagocytosis. Clinical and laboratory results from pre-mortem blood samples were used to calculate H-scores. Findings: All four cases demonstrated DAD within the lungs. Three of the four cases had histologic evidence of hemophagocytosis within pulmonary hilar/mediastinal lymph nodes. One case showed hemophagocytosis in the spleen but none showed hemophagocytosis in liver or bone marrow. Lymphophagocytosis was the predominant form of hemophagocytosis observed. One patient showed diagnostic features of HLH with an H-score of 217 while a second patient was likely HLH with a partial H-score of 145 due to missing triglyceride level. Both patients exhibited high fever and early onset rise in serum ferritin; however, neither bicytopenia, pancytopenia, nor hypofibrinogenemia were observed in either. The remaining two patients had H-scores of 131 and 96. Interpretation: This is the first report of SARS-CoV-2 associated HLH. Identification of HLH in a subset of patients with severe COVID-19 will inform clinical trials of therapeutic strategies.
    Keywords covid19
    Language English
    Publishing date 2020-05-12
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2020.05.07.20094888
    Database COVID19

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  10. Article ; Online: SARS-CoV-2 Infection–Associated Hemophagocytic Lymphohistiocytosis

    Prilutskiy, Andrey / Kritselis, Michael / Shevtsov, Artem / Yambayev, Ilyas / Vadlamudi, Charitha / Zhao, Qing / Kataria, Yachana / Sarosiek, Shayna R / Lerner, Adam / Sloan, J Mark / Quillen, Karen / Burks, Eric J

    American Journal of Clinical Pathology

    2020  Volume 154, Issue 4, Page(s) 466–474

    Abstract: Abstract Objectives A subset of coronavirus disease 2019 (COVID-19) patients exhibit clinical features of cytokine storm. However, clinicopathologic features diagnostic of hemophagocytic lymphohistiocytosis (HLH) have not been reported. We studied the ... ...

    Abstract Abstract Objectives A subset of coronavirus disease 2019 (COVID-19) patients exhibit clinical features of cytokine storm. However, clinicopathologic features diagnostic of hemophagocytic lymphohistiocytosis (HLH) have not been reported. We studied the reticuloendothelial organs of 4 consecutive patients who died of COVID-19 and correlated with clinical and laboratory parameters to detect HLH. Methods Autopsies were performed on 4 patients who died of COVID-19. Routine H&E staining and immunohistochemical staining for CD163 were performed to detect hemophagocytosis. Clinical and laboratory results from premortem blood samples were used to calculate H-scores. Results All 4 cases demonstrated diffuse alveolar damage within the lungs. Three of the 4 cases had histologic evidence of hemophagocytosis within pulmonary lymph nodes. One case showed hemophagocytosis in the spleen but none showed hemophagocytosis in liver or bone marrow. Lymphophagocytosis was the predominant form of hemophagocytosis observed. One patient showed diagnostic features of HLH with an H-score of 217, while a second patient likely had HLH with a partial H-score of 145 due to a missing triglyceride level. The remaining 2 patients had H-scores of 131 and 96. Conclusions This is the first report of severe acute respiratory syndrome coronavirus 2–associated HLH. Identification of HLH in a subset of patients with severe COVID-19 will inform clinical trials of therapeutic strategies.
    Keywords General Medicine ; covid19
    Language English
    Publisher Oxford University Press (OUP)
    Publishing country uk
    Document type Article ; Online
    ZDB-ID 2944-0
    ISSN 1943-7722 ; 0002-9173
    ISSN (online) 1943-7722
    ISSN 0002-9173
    DOI 10.1093/ajcp/aqaa124
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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