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Article: SARS-Associated Viral Hepatitis Caused by a Novel Coronavirus: Report of Three Cases

TitleSARS-Associated Viral Hepatitis Caused by a Novel Coronavirus: Report of Three Cases
Authors
Issue Date2004
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/
Citation
Hepatology, 2004, v. 39 n. 2, p. 302-310 How to Cite?
AbstractLiver impairment is commonly reported in up to 60% of patients who suffer from severe acute respiratory syndrome (SARS). Here we report the clinical course and liver pathology in three SARS patients with liver impairment. Three patients who fulfilled the World Health Organization case definition of probable SARS and developed marked elevation of alanine aminotransferase were included. Percutaneous liver biopsies were performed. Liver specimens were examined by light and electron microscopy, and immunohistochemistry. Reverse-transcriptase polymerase chain reaction (RT-PCR) using enhanced real-time PCR was applied to look for evidence of SARS-associated coronavirus infection. Marked accumulation of cells in mitosis was observed in two patients and apoptosis was observed in all three patients. Other common pathologic features included ballooning of hepatocytes and mild to moderate lobular lymphocytic infiltration. No eosinophilic infiltration, granuloma, cholestasis, fibrosis, or fibrin deposition was noted. Immunohistochemical studies revealed 0.5% to 11.4% of nuclei were positive for proliferative antigen Ki-67. RT-PCR showed evidence of SARS-associated coronavirus in the liver tissues, but not in the sera of all 3 patients. However, electron microscopy could not identify viral particles. No giant mitochondria, micro- or macro-vesicular steatosis was observed. In conclusion, hepatic impairment in patients with SARS is due to SARS-associated coronavirus infection of the liver. The prominence of mitotic activity of hepatocytes is unique and may be due to a hyperproliferative state with or without disruption of cell cycle by the coronavirus. With better knowledge of pathogenesis, specific therapy may be targeted to reduce viral replication and modify the disease course.
Persistent Identifierhttp://hdl.handle.net/10722/77288
ISSN
2015 Impact Factor: 11.711
2015 SCImago Journal Rankings: 4.752
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChau, TNen_HK
dc.contributor.authorLee, KCen_HK
dc.contributor.authorYao, Hen_HK
dc.contributor.authorTsang, TYen_HK
dc.contributor.authorChow, TCen_HK
dc.contributor.authorYeung, YCen_HK
dc.contributor.authorChoi, KWen_HK
dc.contributor.authorTso, YKen_HK
dc.contributor.authorLau, Ten_HK
dc.contributor.authorLai, STen_HK
dc.contributor.authorLai, CLen_HK
dc.date.accessioned2010-09-06T07:30:17Z-
dc.date.available2010-09-06T07:30:17Z-
dc.date.issued2004en_HK
dc.identifier.citationHepatology, 2004, v. 39 n. 2, p. 302-310en_HK
dc.identifier.issn0270-9139en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77288-
dc.description.abstractLiver impairment is commonly reported in up to 60% of patients who suffer from severe acute respiratory syndrome (SARS). Here we report the clinical course and liver pathology in three SARS patients with liver impairment. Three patients who fulfilled the World Health Organization case definition of probable SARS and developed marked elevation of alanine aminotransferase were included. Percutaneous liver biopsies were performed. Liver specimens were examined by light and electron microscopy, and immunohistochemistry. Reverse-transcriptase polymerase chain reaction (RT-PCR) using enhanced real-time PCR was applied to look for evidence of SARS-associated coronavirus infection. Marked accumulation of cells in mitosis was observed in two patients and apoptosis was observed in all three patients. Other common pathologic features included ballooning of hepatocytes and mild to moderate lobular lymphocytic infiltration. No eosinophilic infiltration, granuloma, cholestasis, fibrosis, or fibrin deposition was noted. Immunohistochemical studies revealed 0.5% to 11.4% of nuclei were positive for proliferative antigen Ki-67. RT-PCR showed evidence of SARS-associated coronavirus in the liver tissues, but not in the sera of all 3 patients. However, electron microscopy could not identify viral particles. No giant mitochondria, micro- or macro-vesicular steatosis was observed. In conclusion, hepatic impairment in patients with SARS is due to SARS-associated coronavirus infection of the liver. The prominence of mitotic activity of hepatocytes is unique and may be due to a hyperproliferative state with or without disruption of cell cycle by the coronavirus. With better knowledge of pathogenesis, specific therapy may be targeted to reduce viral replication and modify the disease course.en_HK
dc.languageengen_HK
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/en_HK
dc.relation.ispartofHepatologyen_HK
dc.rightsHepatology. Copyright © John Wiley & Sons, Inc.en_HK
dc.subject.meshAdulten_HK
dc.subject.meshAnti-Inflammatory Agents - therapeutic useen_HK
dc.subject.meshApoptosisen_HK
dc.subject.meshBiopsyen_HK
dc.subject.meshCoronavirus - genetics - isolation & purificationen_HK
dc.subject.meshDNA, Viral - analysisen_HK
dc.subject.meshDrug Combinationsen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHIV Protease Inhibitors - therapeutic useen_HK
dc.subject.meshHepatitis, Viral, Human - drug therapy - pathology - virologyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshLiver - pathology - virologyen_HK
dc.subject.meshLopinaviren_HK
dc.subject.meshMethylprednisolone - therapeutic useen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshMitosisen_HK
dc.subject.meshPyrimidinones - therapeutic useen_HK
dc.subject.meshRitonavir - therapeutic useen_HK
dc.subject.meshSevere Acute Respiratory Syndrome - complications - drug therapy - pathologyen_HK
dc.titleSARS-Associated Viral Hepatitis Caused by a Novel Coronavirus: Report of Three Casesen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0270-9139&volume=39&spage=302&epage=310&date=2004&atitle=SARS-associated+Viral+Hepatitis+Caused+By+A+Novel+Coronavirus:+Report+Of+Three+Casesen_HK
dc.identifier.emailLai, CL:hrmelcl@hku.hken_HK
dc.identifier.authorityLai, CL=rp00314en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/hep.20111en_HK
dc.identifier.pmid14767982-
dc.identifier.scopuseid_2-s2.0-10744229992en_HK
dc.identifier.hkuros87530en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-10744229992&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume39en_HK
dc.identifier.issue2en_HK
dc.identifier.spage302en_HK
dc.identifier.epage310en_HK
dc.identifier.isiWOS:000220375600008-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChau, TN=7102000078en_HK
dc.identifier.scopusauthoridLee, KC=7501503975en_HK
dc.identifier.scopusauthoridYao, H=8103931800en_HK
dc.identifier.scopusauthoridTsang, TY=7101832362en_HK
dc.identifier.scopusauthoridChow, TC=7203012368en_HK
dc.identifier.scopusauthoridYeung, YC=8103932100en_HK
dc.identifier.scopusauthoridChoi, KW=7403949749en_HK
dc.identifier.scopusauthoridTso, YK=36892067900en_HK
dc.identifier.scopusauthoridLau, T=36920292300en_HK
dc.identifier.scopusauthoridLai, ST=7402937038en_HK
dc.identifier.scopusauthoridLai, CL=7403086396en_HK

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