Astrovirus Encephalitis in Boy with X-linked Agammaglobulinemia
Phenix-Lan Quan, Thor A. Wagner, Thomas Briese, Troy R. Torgerson, Mady Hornig, Alla Tashmukhamedova, Cadhla Firth, Gustavo Palacios, Ada Baisre-De-Leon, Christopher D. Paddock, Stephen K. Hutchison, Michael Egholm, Sherif R. Zaki, James E. Goldman, Hans D. Ochs, and W. Ian Lipkin
Author affiliations: Author affiliations: Columbia University, New York, New York, USA (P.-L. Quan, T. Briese, M. Hornig, A. Tashmukhamedova, G. Palacios, A. Baisre-De-Leon, J.E. Goldman, W.I. Lipkin); University of Washington, Seattle, Washington, USA (T.A. Wagner, T.R. Torgerson, H.D. Ochs); Seattle Children’s Hospital, Seattle (T.A. Wagner, T.R. Torgerson, H.D. Ochs); Pennsylvania State University, Pittsburgh, Pennsylvania, USA (C. Firth); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (C.D. Paddock, S.R. Zaki); and 454 Life Sciences, Branford, Connecticut, USA (S.K. Hutchison, M. Egholm)
Figure 1. Histologic findings from brain of 15-year-old boy with X-linked agammaglobulinemia and encephalitis. A) Frontal cortex with cortical thinning (double-headed arrow) and vacuolation (arrows) (Luxol fast blue stain with periodic acid–Schiff method [LFB/PAS], original magnification ×10). B) Frontal cortex with vacuolation (arrow) and rare residual neurons (arrowheads) (LFB/PAS, original magnification ×50). C) Marked astrogliosis in the frontal cortex (glial fibrillary acidic protein [GFAP] immunostain, original magnification ×100). D) White matter with marked astrogliosis (GFAP immunostain, original magnification ×100). E) Penetrating artery with abundant CD3+ T-cells in the perivascular space and adjacent brain parenchyma (CD3+ immunostain, original magnification ×25). F) CD3+ T-cells as part of microglial nodules (CD3+ immunostain, original magnification ×100). G) White matter in the internal capsule showing myelin clumps (arrowheads) and vacuolation (arrow) (LFB/PAS, original magnification ×100). H) Loss of axons in the internal capsule (Bielschowsky nerve fiber silver stain, original magnification ×100). I) Internal capsule with marked microgliosis (CD68+ immunostain, original magnification ×40). J) Microcalcifications (arrow) in the globus pallidus (LFB/PAS, original magnification ×100). All paraffin sections were counterstained with hematoxylin.
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