PMID- 34238966
OWN - NLM
STAT- MEDLINE
DCOM- 20211102
LR  - 20240402
IS  - 2045-2322 (Electronic)
IS  - 2045-2322 (Linking)
VI  - 11
IP  - 1
DP  - 2021 Jul 8
TI  - Retrospective review of 27 European cases of fatal elephant endotheliotropic 
      herpesvirus-haemorrhagic disease reveals evidence of disseminated intravascular 
      coagulation.
PG  - 14173
LID - 10.1038/s41598-021-93478-0 [doi]
LID - 14173
AB  - Elephant endotheliotropic herpesvirus haemorrhagic disease (EEHV-HD) is widely 
      acknowledged as the most common cause of mortality in young Asian elephants 
      (Elephas maximus) in captivity. The objective of the current study was to perform 
      a blinded, retrospective pathology review of European EEHV-HD fatalities, 
      constituting the largest systematic assessment of EEHV-HD pathology to date. 
      Findings between viral genotypes were compared with the aim to investigate if 
      disseminated intravascular coagulation (DIC) could be substantiated as a 
      significant complicating factor, thereby increasing the understanding of disease 
      pathophysiology. Immunohistochemical staining confirmed endothelial cell (EC) 
      damage and the presence of EC intranuclear inclusion bodies, demonstrating a 
      direct viral cytopathic effect. Microthrombi were observed in 63% of cases in 
      several organs, including lungs, which, together with widespread haemorrhage and 
      thrombocytopenia reported in EEHV-HD case reports, supports the presence of overt 
      DIC as a serious haemostatic complication of active EEHV infection. Death was 
      attributed to widespread vascular damage with multi-organ dysfunction, including 
      severe acute myocardial haemorrhage and subsequent cardiac failure. Systemic 
      inflammation observed in the absence of bacterial infection may be caused by 
      cytokine release syndrome. Findings reinforce the necessity to investigate 
      cytokine responses and haemostatic status during symptomatic and asymptomatic 
      EEHV viraemia, to potentially support the use of anti-inflammatory treatment in 
      conjunction with anti-viral therapy and cardiovascular support.
FAU - Perrin, K L
AU  - Perrin KL
AD  - Center for Zoo and Wild Animal Health, Copenhagen Zoo, Roskildevej 38, 2000, 
      Frederiksberg, Denmark. klperrin01@gmail.com.
AD  - The Department of Veterinary Clinical Sciences, Faculty of Health and Medical 
      Sciences, University of Copenhagen, Dyrlaegevej 16, 1870, Frederiksberg, Denmark. 
      klperrin01@gmail.com.
FAU - Kristensen, A T
AU  - Kristensen AT
AD  - The Department of Veterinary Clinical Sciences, Faculty of Health and Medical 
      Sciences, University of Copenhagen, Dyrlaegevej 16, 1870, Frederiksberg, Denmark.
FAU - Bertelsen, M F
AU  - Bertelsen MF
AD  - Center for Zoo and Wild Animal Health, Copenhagen Zoo, Roskildevej 38, 2000, 
      Frederiksberg, Denmark.
FAU - Denk, D
AU  - Denk D
AD  - International Zoo Veterinary Group, Station House, Parkwood Street, Keighley, 
      BD21 4NQ, UK.
AD  - Institute for Animal Pathology, Ludwig-Maximilians-University, Veterinarstr. 13, 
      80539, Munich, Germany.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210708
PL  - England
TA  - Sci Rep
JT  - Scientific reports
JID - 101563288
SB  - IM
MH  - Animals
MH  - Disseminated Intravascular Coagulation/pathology/*veterinary/*virology
MH  - Edema/pathology
MH  - Elephants/*virology
MH  - Hemorrhage/pathology/*veterinary/*virology
MH  - Herpesviridae/*physiology
MH  - Herpesviridae Infections/pathology/*veterinary/*virology
MH  - Inclusion Bodies, Viral/metabolism
MH  - Inflammation/pathology
MH  - Lymph Nodes/pathology
MH  - Organ Specificity
MH  - Retrospective Studies
MH  - Severity of Illness Index
PMC - PMC8266883
COIS- The authors declare no competing interests.
EDAT- 2021/07/10 06:00
MHDA- 2021/11/03 06:00
PMCR- 2021/07/08
CRDT- 2021/07/09 06:29
PHST- 2021/01/17 00:00 [received]
PHST- 2021/06/25 00:00 [accepted]
PHST- 2021/07/09 06:29 [entrez]
PHST- 2021/07/10 06:00 [pubmed]
PHST- 2021/11/03 06:00 [medline]
PHST- 2021/07/08 00:00 [pmc-release]
AID - 10.1038/s41598-021-93478-0 [pii]
AID - 93478 [pii]
AID - 10.1038/s41598-021-93478-0 [doi]
PST - epublish
SO  - Sci Rep. 2021 Jul 8;11(1):14173. doi: 10.1038/s41598-021-93478-0.