Electron microscopic study of the vascular endothelial cell in dengue hemorrhagic fever.

Electron microscopic studies were performed from skin biopsies taken from patients aged between 1-14 years suffering from dengue hemorrhagic fever. Several capillaries showed marked distortion, but severely damaged vessels were not observed in this study. In many cases, however, swelling of a single endothelial cell was noted. This was characterized by a rarefaction of the cytoplasm and formation of the plasma membrane which extruded into lumen and narrowed it. In many vessels examined, these blebs became detached from the endothelium and were found free within the capillary lumen. Myelin figures were often observed in such vessels. Mitochondria in the swollen endothelial cells often showed contraction of the inner compartments. Although, most of the endothelial junctional complexes were intact, several gap formations, in vascular wall were observed. Vacuolation of the cytoplasm and increase in the pinocytotic vesicles in endothelial cells which represented transport of plasma fluids from the capillary to the pericapillary space were quite evident. In no case did there seem to be marked alternation of the basement membrane of the capillary. The morphological alterations observed in this study only suggest the non-specific response of the dermal capillaries. These findings were similar to the findings observed in capillaries after being subjected to heat or ischemia.