Am J Forensic Med Pathol. 2021 Dec 22; doi: 10.1097/PAF.0000000000000737. Epub 2021 Dec 22.
The American journal of forensic medicine and pathology
Christine James, Diane C Peterson
PMID: 34939946 DOI: 10.1097/PAF.0000000000000737
ABSTRACT: Spontaneous multiple arterial dissection (SMAD) is a rarely reported phenomenon and has been previously linked to connective tissue diseases and specifically the genetic mutations in SMAD3 and COL3A1. Herein we describe a case of SMAD with scattered thrombi in a COVID-19-positive patient with a history of unspecified mitochondrial myopathy. Vasculopathy involved the splenic artery, inferior mesenteric artery, internal mammary arteries, omental arteries, mesenteric arteries, and small renal arteries. Dissections were confirmed by histology in the splenic artery, inferior mesenteric artery, and bilateral renal medullary arteries. Genetic studies were done to rule out SMAD3 and COL3A1 mutations. Because the Smad3 protein has been previously implicated in COVID-19-associated tissue fibrosis, it may play a role in endothelial dysfunction as well.
Copyright © 2021 by Lippincott Williams & Wilkins.
