{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T19:27:32Z","timestamp":1750102052182},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2012,6,20]],"date-time":"2012-06-20T00:00:00Z","timestamp":1340150400000},"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":["Int J Dermatology"],"published-print":{"date-parts":[[2012,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Background\u2002<\/jats:bold> Herpes virus infections are well known infectious complications of pemphigus and bullous pemphigoid. We describe pathologic findings utilizing autopsy tissue from several organs from a patient affected by a new variant of endemic pemphigus in El Bagre, Colombia, South America.<\/jats:p><jats:p><jats:bold>Case report\u2002<\/jats:bold> We describe a patient by a new variant of endemic pemphigus foliaceus from El Bagre that was receiving high\u2010dosage immunosuppressants when hospitalized and died suddenly following contact with a second patient affected by chicken pox.<\/jats:p><jats:p><jats:bold>Materials and methods\u2002<\/jats:bold> We performed studies utilizing hematoxylin and eosin, immunohistochemistry, and direct immunofluorescence techniques on tissues from several organs.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> We detected the presence of varicella zoster virus, as well as strong positivity for \u03b1\u20101 antitrypsin in the heart, kidneys, spleen, liver, skin, brain, lungs, pancreas, small and large intestines, and skeletal muscle. In regard to structural damage in the kidney and heart, we believe the observed damage is associated with the presence of autoantibodies to these organs, since both of them are rich in plakins and El Bagre\u2010EPF patients present significant antibodies to plakin molecules.<\/jats:p><jats:p><jats:bold>Conclusion\u2002<\/jats:bold> In patients with endemic pemphigus foliaceus, we recommend complete isolation of the patient when receiving high dosages of systemic immunosuppressive agents. We further suggest the clinical possibility of a synergistic, fatal interaction between active pemphigus foliaceus, varicella zoster virus, herpes simplex virus, immunosuppressive agents, and a systemic activation of \u03b1\u20101 antitrypsin. Thus, we suggest adequate bed spacing, barrier nursing, and preventative testing for \u03b1\u20101 antitrypsin activation are warranted in these patients to address these complications.<\/jats:p>","DOI":"10.1111\/j.1365-4632.2011.05296.x","type":"journal-article","created":{"date-parts":[[2012,6,21]],"date-time":"2012-06-21T13:29:06Z","timestamp":1340285346000},"page":"809-816","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Varicella\u2010zoster virus (VZV) and alpha 1 antitrypsin: a fatal outcome in a patient affected by endemic pemphigus foliaceus"],"prefix":"10.1111","volume":"51","author":[{"given":"Ana Maria","family":"Abreu Velez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce R.","family":"Smoller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weiqing","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans E.","family":"Grossniklaus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhe","family":"Jiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis F.","family":"Arias","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Samuel C.","family":"Dudley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael S.","family":"Howard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,6,20]]},"reference":[{"key":"e_1_2_5_2_2","first-page":"651","article-title":"Contribution to the etiology, diagnosis and therapy of pemphigue","volume":"51","author":"Macht D","year":"1947","journal-title":"Urol Cutaneous Rev"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1159\/000246401"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0339(199812)19:6<446::AID-DC8>3.0.CO;2-2"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.2008.02989.x"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.medmal.2008.06.032"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2008.08854.x"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.2007.02674.x"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.4103\/0378-6323.30649"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2004.10.882"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1067\/S0190-9622(03)00851-X"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.2009.01315.x"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2009.06.007"},{"key":"e_1_2_5_14_2","first-page":"359","article-title":"The tryptic cleavage product of the mature form of the bovine desmoglein 1 ectodomain is one of the antigen moieties immunoprecipitated by all sera from symptomatic patients affected by a new variant of endemic pemphigus","volume":"13","author":"Abr\u00e9u\u2010V\u00e9lez AM","year":"2003","journal-title":"Eur J Dermatol"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00403-003-0441-4"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00403-009-0972-4"},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10875-010-9495-1"},{"key":"e_1_2_5_18_2","first-page":"526","article-title":"Subcorneal pustular dermatosis an immnohisto\u2010pathological perspective","volume":"4","author":"Abreu Velez AM","year":"2011","journal-title":"Int J Clin Exp Pathol"},{"key":"e_1_2_5_19_2","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.73.10.8571-8577.1999"},{"key":"e_1_2_5_20_2","first-page":"353","article-title":"Erup\u00e7\u00e3o variceliforme de kaposi por v\u00edrus vac\u00ednico em doente com p\u00eanfigo foli\u00e1ceo. 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