{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:07:39Z","timestamp":1792098459696,"version":"4.4.0"},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,11,21]],"date-time":"2017-11-21T00:00:00Z","timestamp":1511222400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>The pathogenesis, viral localization and histopathological features of Middle East respiratory syndrome \u2013 coronavirus (<jats:styled-content style=\"fixed-case\">MERS<\/jats:styled-content>\u2010CoV) in humans are not described sufficiently. The aims of this study were to explore and define the spectrum of histological and ultrastructural pathological changes affecting various organs in a patient with <jats:styled-content style=\"fixed-case\">MERS<\/jats:styled-content>\u2010CoV infection and represent a base of <jats:styled-content style=\"fixed-case\">MERS<\/jats:styled-content>\u2010CoV histopathology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>We analysed the post\u2010mortem histopathological findings and investigated localisation of viral particles in the pulmonary and extrapulmonary tissue by transmission electron microscopic examination in a 33\u2010year\u2010old male patient of T cell lymphoma, who acquired <jats:styled-content style=\"fixed-case\">MERS<\/jats:styled-content>\u2010CoV infection. Tissue needle biopsies were obtained from brain, heart, lung, liver, kidney and skeletal muscle. All samples were collected within 45 min from death to reduce tissue decomposition and artefact. Histopathological examination showed necrotising pneumonia, pulmonary diffuse alveolar damage, acute kidney injury, portal and lobular hepatitis and myositis with muscle atrophic changes. The brain and heart were histologically unremarkable. Ultrastructurally, viral particles were localised in the pneumocytes, pulmonary macrophages, renal proximal tubular epithelial cells and macrophages infiltrating the skeletal muscles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results highlight the pulmonary and extrapulmonary pathological changes of <jats:styled-content style=\"fixed-case\">MERS<\/jats:styled-content>\u2010CoV infection and provide the first evidence of the viral presence in human renal tissue, which suggests tissue trophism for <jats:styled-content style=\"fixed-case\">MERS<\/jats:styled-content>\u2010CoV in kidney.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.13379","type":"journal-article","created":{"date-parts":[[2017,8,31]],"date-time":"2017-08-31T15:02:41Z","timestamp":1504191761000},"page":"516-524","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":258,"title":["Histopathology of Middle East respiratory syndrome coronovirus (<scp>MERS<\/scp>\u2010CoV) infection \u2013 clinicopathological and ultrastructural study"],"prefix":"10.1111","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3389-9035","authenticated-orcid":false,"given":"Khaled O","family":"Alsaad","sequence":"first","affiliation":[{"name":"Division of Anatomical Pathology Department of Pathology and Laboratory Medicine King Abdulaziz Medical City Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali H","family":"Hajeer","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center Riyadh Saudi Arabia"},{"name":"Division of Immunopathology Department of Pathology and Laboratory Medicine King Abdulaziz Medical City Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Al Balwi","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center Riyadh Saudi Arabia"},{"name":"Division of Molecular Genetics and Cytogenetics Department of Pathology and Laboratory Medicine King Abdulaziz Medical City Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Al Moaiqel","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center Riyadh Saudi Arabia"},{"name":"Department of Medical Imaging King Abdulaziz Medical City Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nourah","family":"Al Oudah","sequence":"additional","affiliation":[{"name":"Division of Anatomical Pathology Department of Pathology and Laboratory Medicine King Abdulaziz Medical City Riyadh Saudi Arabia"},{"name":"King Abdullah International Medical Research Center Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulaziz","family":"Al Ajlan","sequence":"additional","affiliation":[{"name":"Division of Anatomical Pathology Department of Pathology and Laboratory Medicine King Abdulaziz Medical City Riyadh Saudi Arabia"},{"name":"King Abdullah International Medical Research Center Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameera","family":"AlJohani","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center Riyadh Saudi Arabia"},{"name":"Division of Microbiology Department of Pathology and Laboratory Medicine King Abdulaziz Medical City Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Alsolamy","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center Riyadh Saudi Arabia"},{"name":"Department of Intensive Care King Abdulaziz Medical City Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giamal E","family":"Gmati","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center Riyadh Saudi Arabia"},{"name":"Division of Hematology Department of Oncology King Abdulaziz Medical City Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanan","family":"Balkhy","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center Riyadh Saudi Arabia"},{"name":"Department of Infection Prevention and Control and Division of Infectious Diseases Department of Pediatrics King Abdulaziz Medical City Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamdan H","family":"Al\u2010Jahdali","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center Riyadh Saudi Arabia"},{"name":"Division of Pulmonology Department of Medicine King Abdulaziz Medical City Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salim A","family":"Baharoon","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center Riyadh Saudi Arabia"},{"name":"Department of Intensive Care King Abdulaziz Medical City Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaseen M","family":"Arabi","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center Riyadh Saudi Arabia"},{"name":"Department of Intensive Care King Abdulaziz Medical City Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,21]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2016.132"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1211721"},{"key":"e_1_2_7_4_1","unstructured":"World Health Organization.Middle East respiratory syndrome coronavirus (MERS\u2010CoV). Available at:http:\/\/www.who.int\/emergencies\/mers-cov\/en\/(accessed 14 July 2017)."},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.7326\/M13-2486"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2015.30.12.1807"},{"key":"e_1_2_7_7_1","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1186\/1743-422X-10-359","article-title":"In\u2010vitro renal epithelial cell infection reveals a viral kidney tropism as a potential mechanism for acute renal failure during Middle East Respiratory Syndrome (MERS) coronavirus infection","volume":"23","author":"Eckerle I","year":"2013","journal-title":"Virol. 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