Virus-infected peripheral blood plasmablasts in a patient with severe fever with thrombocytopenia syndrome
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ORIGINAL ARTICLE
Virus‑infected peripheral blood plasmablasts in a patient with severe fever with thrombocytopenia syndrome Toru Takahashi1 · Kaori Sano2 · Tadaki Suzuki2 · Takuro Matsumura1 · Kohei Sakai1 · Takayuki Tominaga1 · Yuko Sato2 · Harutaka Katano2 · Hideki Hasegawa2 Received: 26 July 2020 / Revised: 30 October 2020 / Accepted: 6 November 2020 © Japanese Society of Hematology 2020
Abstract Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne viral hemorrhagic disease with a high fatality rate. It is caused by the SFTS virus and is endemic in East Asian countries such as China, South Korea, and Japan. Previous studies have shown that plasmablasts appear transiently in peripheral blood during the acute phase of SFTS, but do not specify the characteristics of these plasmablasts. In this report, we describe the features of peripheral blood plasmablasts in a patient with SFTS. Immunohistochemical and immunofluorescence staining detected a small number of atypical lymphocytes expressing the SFTS virus antigen among peripheral leukocytes in a blood sample. The phenotype of the virus-infected cells was CD27+, CD38+, MUM1+, and CD138+, which is consistent with that of plasmablasts. This novel study demonstrates that plasmablasts in the peripheral blood of patients with SFTS are targets of the SFTS virus. Keywords Severe fever with thrombocytopenia syndrome · Tick-borne infection · Viral hemorrhagic fever · SFTS virus · Plasmablasts
Introduction Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne viral hemorrhagic disease with a high fatality rate [1–3]. The number of SFTS patients in endemic East Asian countries such as China, South Korea, and Japan has increased in recent years [2, 4, 5]. Additionally, zoonotic transmission of the SFTS virus (SFTSV) from cats to humans [6] makes SFTS a significant public health concern. A recent study of autopsy tissues from fatal SFTS cases shows that SFTSV targets B cells differentiating into plasmablasts [7]. In addition, plasmablasts appear transiently in the peripheral blood during the acute phase of SFTS [8–10]. Thus, B cells and plasmablasts play an important role in the Toru Takahashi and Kaori Sano contributed equally to this study. * Toru Takahashi ttakahashi‑[email protected] 1
Department of Hematology, Yamaguchi Prefectural Grand Medical Center, 10077 Osaki, Hofu, Yamaguchi 747‑8511, Japan
Department of Pathology, National Institute of Infectious Diseases, 1‑23‑1 Toyama, Shinjuku, Tokyo 162‑8640, Japan
2
pathogenesis of SFTS. However, the relationship between the two in SFTS patients is unclear. This study aimed to determine whether peripheral blood plasmablasts in a patient with SFTS were the targets of SFTSV.
Materials and methods Case details In May 2019, a 72-year-old man was bitten several times on both hands by a sick cat. The cat was later diagnosed with SFTS. Owing to fever, fatigue, and vomiting beginning 9 days after the cat bite, the patient visited a local hospital. 5 days later, he was referred to the Yamaguchi P
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