fibrin and Herpes-Simplex

A 74-year-old female developed pneumonia following herpes simplex encephalitis. Her white blood cell counts reached 28,400/microliters, about 90% of which consisted of granulocytes. The polymorphonuclear (PMN) elastase/alpha 1-antitrypsin complex levels increased and reached the maximum of 5,019 ng/ml, indicating the release of a large amount of elastase derived from the granulocytes. The mechanism of PMN elastase release was most likely to be granulocyte destruction associated with phagocytosis. The cleavage of fibrinogen and fibrin by PMN elastase, independent of plasmin, was indicated by the presence of the fragments in immunoprecipitated plasma from the patient corresponding to elastase-induced FDP D and DD fragments and the absence of fragments corresponding to plasmin-induced FDP D and DD fragments on SDS-PAGE. These findings suggested that the large amount of PMN elastase released from the excessive numbers of granulocytes in this patient with herpes simplex encephalitis and pneumonia, induced the cleavage of fibrinogen and fibrin without the participation of plasmin.

Topics: Aged; Encephalitis, Viral; Female; Fibrin; Fibrinogen; Herpes Simplex; Humans; Opportunistic Infections; Pancreatic Elastase; Pneumonia

In a prospective study of erythema multiforme, forty-two cases were selected with the use of defined criteria. In thirty-three cases (79%), the erythema multiforme occurred following a lesion of recurrent herpes simplex; in four cases (10%), it was related to administration of a sulfonamide drug. Herpes-associated erythema multiforme (HEM) was largely recurrent erythema multiforme minor and was characterized histopathologically by inflammatory changes, such as spongiosis and exocytosis, and by focal liquefaction degeneration of the basal cell zone of the epidermis. Sulfa-associated erythema multiforme (SEM) was a nonrecurrent illness with widespread cutaneous and mucosal damage associated with prominent histologic necrosis of epidermal cells. The deposition of C3 and fibrin along the dermoepidermal junction and the deposition of IgM, C3, and fibrin around dermal blood vessels by immunofluorescence microscopy were similar in both groups. Although HEM and SEM may have somewhat different clinical and histologic features, there is significant overlap in the pattern of tissue damage.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Complement C3; Epidermis; Erythema Multiforme; Female; Fibrin; Herpes Simplex; Humans; Immunoglobulin M; Male; Middle Aged; Necrosis; Prospective Studies; Recurrence; Sulfonamides

Topics: Adolescent; Adult; Aged; Candidiasis; Child; Child, Preschool; Deglutition Disorders; Epithelial Cells; Esophagitis; Female; Fibrin; Heart; Herpes Simplex; Humans; Lung; Male; Middle Aged; Necrosis; Pneumonia; Respiratory Tract Infections; Simplexvirus; Trachea

Topics: Autopsy; Blood Cell Count; Blood Coagulation Disorders; Blood Coagulation Tests; Blood Platelets; Cytopathogenic Effect, Viral; Erythrocytes; Fibrin; Fibrinogen; Hemorrhage; Herpes Simplex; Humans; Infant, Newborn; Infant, Newborn, Diseases; Prothrombin Time