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Histopathological/ultrastructural analysis and dengue detection in the kidney.

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posted on 15.04.2014 by Tiago F. Póvoa, Ada M. B. Alves, Carlos A. B. Oliveira, Gerard J. Nuovo, Vera L. A. Chagas, Marciano V. Paes

(a) Kidney of a non-dengue case stained with HE and presenting normal aspect. (b and c) Kidney sections of dengue cases, stained with HE, showing injuries, including: hemorrhage (He), edema (E), sloughing of necrotic cells with loss of the basement membrane (black star), mainly in proximal convoluted tubule (PCT) but also detected in distal convoluted tubule (DCT), and areas of cellular regeneration (blue star) near renal glomerulus (RG). (d and e) Semi-thin sections of non-dengue cases showing Bowman’s capsule (BC) and podocytes (Pdc) around glomerular capillaries (GC), mensagial cells (MC) and endothelial cell (EC) with regular structures and preserved capillaries (Cap), epithelial cells (Ep) and distal and proximal convolutes tubules (DCT and PCT, respectively). (f and g) Dengue cases with the presence of thrombus (T) in capillaries of renal glomerulus and necrotic cells (NC) in the lumen of proximal convoluted tubules. (h) Ultrathin of a non-dengue case exhibiting conserved glomerular capillaries. (i) Ultrathin of one dengue case showing necrotic cell with picnotic nucleus (white star) and dilatation of rough endoplasmic reticulum (ER). Quantitative analysis of hemorrhage (j) and edema (k) observed in dengue (cases 1–4) and non-dengue patients (cont. 1–4), and statistical analysis performed comparing the mean values of each group (dengue patients vs non-dengue patients). Asterisks indicate differences that are statistically significant between control and dengue groups, (*) (P<0.05). Semi-thin and ultrathin sections were stained as described in figure 1, as well as damage quantifications. (l) Detection of DENV-3 antigens by immunochemistry in macrophages (M□) and monocytes (Mo) and (m) quantification of cells presenting these antigens.