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Medical Research

Chronic histiocytic intervillositis – Clinical, biochemical and radiological findings: An observational study (Koby et. al)

This ‘retrospective observational’ study (which means a study where they look at people who were diagnosed with CHI and looked back to see if there was anything special about their pregnancies) looked at 33 pregnancies with confirmed ‘CHI’ in Toronto, Canada. They looked at blood results and ultrasound results as well as the overall health […]

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Chronic histiocytic intervillositis in three consecutive pregnancies in a single patient: Differing clinical results and pathology according to treatment used. (Ozawa et. al.)

This is a case study series looking at 3 subsequent pregnancies in a woman who has unfortunately had 4 previous early miscarriages and been diagnosed with CHI. They found that pregnancy outcomes changed depending on treatment with the most successful being a combination of low dose aspirin and prednisolone. File: Ozawa et al. – Chronic histiocytic […]

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Chronic villitis of unknown etiology and massive chronic intervillositis have similar immune cell composition. (Labarrere et. al 2015)

This study looks in detail at the type of immune cells that are found in placentas with CVUE and MCI. It hypotheseses that these might be differing severities of the same underlying pathology. It also explicitly states two different ideas as to what causes CVUE/MCI – either due to the fetus responding to an infectious […]

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Medical Research

An Immunological Basis for Chronic Histiocytic Intervillositis in Recurrent Fetal Loss. (Reus et. al)

Reus et al. – An Immunological Basis for Chronic Histiocytic Intervillositis in Recurrent Fetal Loss – 2013 – American Journal of Reproductive Immunology This paper ‘scores’ or grades placentas as to how many/much lesions associated with CHI and finds that a higher score (more lesions) is associated with worse outcomes and is considered to be […]

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Successful pregnancy following treatment of recurrent chronic histiocytic intervillositis (Vardi et. al) – 2017

This New Zealand case report looks at a woman who had recurrent pregnancy loss and was diagnosed with CHI. A subsequent pregnancy was successful with a combination of therapy including: prednisone, enoxaparin, calcium and aspirin, close monitoring with regular growth scans, and an elective c-section at 34 weeks when it was seen the baby’s growth was […]

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Recurrent Chronic Histiocytic Intervillositis with Intrauterine Growth Restriction, Osteopenia, and Fractures (Crawford et. al) – 2016

This Australian paper looks at a single woman who unfortunately had 4 pregnancies affected by CHI. Her fetuses also appeared to have a bone condition (osteogenesis imperfecta – OI) although the histology (looking down a microscope) of the bones didn’t match typical OI and she didn’t have any genetic markers for it either.   Crawford […]

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Medical Research

Expression of Toll-Like Receptors in Chronic Histiocytic Intervillositis of the Placenta. (Hussein K, Stucki-Koch A, Kreipe H, et al.)

This paper notes the previously known histological (looking down the microscope) similarity between placental malaria and CHI and suggests that they may both result/be due to cells ‘expressing’ receptors on their surface. They looked at cells from CHI placentas as well as cells from normal placentas and those from CVUE placentas and found that there […]

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Medical Research

Chronic histiocytic intervillositis: Outcome, associated diseases and treatment in a multicenter prospective study.

Chronic histiocytic intervillositis: Outcome, associated diseases and treatment in a multicenter prospective study. Citation: Mekinian A, Costedoat-Chalumeau N, Masseau A, et al. Chronic histiocytic intervillositis: Outcome, associated diseases and treatment in a multicenter prospective study. Autoimmunity 2014;6934:1–6. doi:10.3109/08916934.2014.939267 Introduction: In this prospective multicenter study, we aimed to describe (1) the outcome of pregnancy in the case […]

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Expression analysis of leukocytes attracting cytokines in chronic histiocytic intervillositis of the placenta: Freitag, von Kaisenberg, Kreipe, Hussein

Abstract: Chronic histiocytic intervillositis of the placenta (CHI) is a rare and potentially recurrent disease. Characteristically it shows accumulation of CD68+ cells in the intervillous space but no destructive tissue infiltration. An immunopathological background is likely but it is unknown what attracts circulating monocytes to the placenta. Methods: We analysed the expression profile of 102 inflammation- […]

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Fetal death in primary Sjögren’s syndrome (SS) associated with chronic intervillositis. Arsene Mekinian

Letter to the Editor (case report) SIR, Chronic intervillositis is a rare and poorly understood disease characterized by intervillous infiltrates of maternal origin. The intervillositis infiltrates from mononuclear cells (monocytes, histiocytes) correlate with placental insufficiency, and result in intrauterine growth restriction, intrauterine fetal death and spontaneous miscarriage [1]. Chronic intervillositis aetiology is not well established. […]

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Medical Research

Fetal Demise Associated With Influenza A Infection. Richard Lieberman, MD

DIAGNOSES: Intrauterine fetal demise (second trimester). Diffuse villous fibrosis, perivillous and intravillous fibrin deposition associated with chronic villitis and intervillositis (placentitis), histiocytic type. Influenza A virus infection (type not specified) with ultrastructural, immunohistochemical, and PCR confirmation. CASE 2: Fetal Demise Associated With Influenza A Infection. Richard Lieberman, MD

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Medical Research

CD68 Immunostaining in the Evaluation of Chronic Histiocytic Intervillositis. Debra S. Heller, MD

Context.—Chronic histiocytic intervillositis is an uncommon and poorly recognized lesion associated with poor perinatal outcomes, including intrauterine growth retardation and stillbirth. It has a high recurrence rate. Objective.—To evaluate utility of CD68 immunostaining in the evaluation of chronic histiocytic intervillositis. Design.—Institutional review board–approved retrospective review was performed. Cases were selected from the departmental archives of […]

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Medical Research

Co-occurrence of Massive Perivillous Fibrin Deposition and Chronic Intervillositis: Case Report

ABSTRACT Chronic intervillositis (CI) and massive perivillous fibrin deposition (MFD), together with its related entity, maternal floor infarction (MFI), are rare and poorly understood placental lesions. Both MFD/MFI and CI are associated with poor fetal outcome and high risk of recurrence. We report a patient who was found to have both MFD and CI in […]

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Medical Research

Combining corticosteroid and aspirin for the prevention of recurrent villitis or intervillositis of unknown etiology

Summary (translation from the original paper in French): We report the cases of two patients who had a favourable outcome with aspirin and corticosteroid therapy during pregnancy for chronic villitis of unknown etiology complicated by labor asphyxia and further intrauterine fetal demise in one gravida 3 patient and for chronic intervillositis of unknown etiology diagnosed […]

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Medical Research

Association des corticoïdes à l’aspirine pour la prévention des récidives de villite ou d’intervillite chroniques d’étiologie indéterminée

RÉSUMÉ- Article en Français Les auteurs rapportent les résultats favorables obtenus en cours de grossesse par l’association aspirine et corticoïdes, d’une part, chez une patiente troisième geste ayant présenté des lésions placentaires de villite chronique d’étiologie indé- terminée, compliquée d’une asphyxie fœtale pendant le travail, puis d’une mort in utero, d’autre part, chez une quatrième […]

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Chronic histiocytic intervillositis of unknown etiology: Clinical features in a consecutive series of 69 cases: Marchaudon et. al

(Summary to come!) Chronic histiocytic intervillositis of unknown etiology: Clinical features in a consecutive series of 69 cases: Marchaudon et. al

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Medical Research

Chronic intervillositis of unknown etiology (CIUE) – Relation between placental lesions and perinatal outcome

This study talks about Chronic intervillositis of unknown etiology (CIUE) which appears to be yet another term for CHI/CHIV/MCI. It looks at 20 pregnancies across 14 women affected by CIUE; 10 resulted in live births and the recurrence rate for multiple pregancies was 100% (it should be noted however, that this is a smaller sample […]

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Medical Research

Chronic villitis of unknown etiology: Georges Boog (2008)

CVUE is thought to be different but a similar and more common disease compared to CHI. It talks about associations with maternal BMI, multiple pregnancies and ethnicity. It also found it showed up in pregnancies affected by autoimmune or alloimmune diseases. It suggests aspirin and corticosteroids as a possible regimen. Chronic villitis of unknown etiology: […]

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Villitis of unknown etiology – noninfectious chronic villitis in the placenta: Raymond W. Redline MD

This talks about Villitis of unknown etiology (VUE) which I guess becomes Chronic Villitis of unknown etiology (CVUE) if you have it for life rather than as a result of an acute condition? It describes how this more common condition can affect 5-15% of pregnancies and, as you’d expect from those sort of numbers, isn’t […]

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Massive perivillous fibrin deposition and chronic intervillositis: frequently missed diagnoses with a high recurrence risk: MA Weber, PGJ Nikkels, KE Hamoen, JJ Duvekot, RR de Krijger

This study talks about MFD/MFI and CI as similar conditions both of which are very rare. It looks at one case study and talks about how the diseases may be similar. It mentions heparin-type drugs and immunosuppresants as possible treatment options. Its focus is to encourage better diagnosis of this condition to improve standards of […]

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Chronic villitis in untreated neonatal alloimmune thrombocytopenia: An etiology for severe early intrauterine growth restriction and the effect of intravenous immunoglobulin therapy.

This study looks at CHIV in the specific case of neonatal alloimmune thrombocytopenia. It suggests that intravenous immunoglobulin given to the mother may help improve the outcome although the results weren’t statistically significant because there weren’t enough case studies. Chronic villitis in untreated neonatal alloimmune thrombocytopenia: An etiology for severe early intrauterine growth restriction and […]

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Medical Research

Massive Chronic Intervillositis Associated With Recurrent Abortions: Barbara J. Doss

This covers a specific case of MCI/CHIV in a lady who had 10 recurrent miscarriages in her first and second trimesters (although she also had two live births as well!). They look at each pregnancy and try to find similarities and differences between them. Other than that, it draws many similar conclusions as other studies. […]

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Medical Research

A combination treatment of prednisone, aspirin, folate, and progesterone in women with idiopathic recurrent miscarriage: a matched-pair study Clemens B. Tempfer, M.D. et al

This study looks at a treatment in the form of prednisone, aspirin, folate, and progesterone in women who had suffered from more than three miscarriages. It found a statistically significant and positive effect in treating women with this regimen compared to those who weren’t treated. The comment on the study is about how valuable the […]

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Medical Research

The placenta in preterm birth: O M Faye-Petersen (2008)

This is a general paper for pathologists who may need to give a report on a preterm placenta. It talks about lots of different types of issues with placentas and covers of CVUE or VUA as it calls it and also mentions MCI but only very briefly. The placenta in preterm birth: O M Faye-Petersen […]

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Medical Research

Prevalence of Developmental and Inflammatory Lesions in Nonmolar First-Trimester Spontaneous Abortions: Raymond W, Redline, MD, Michael Zaragoza, and Terry Hassold, PhD

This study concentrates only on first trimester miscarriages. It identifies CHIV/MCI as one of the features that shows up when the fetus does not appear to have DNA problems (has normal karotypes) and yet a miscarriage took place. Prevalence of Developmental and Inflammatory Lesions in Nonmolar First-Trimester Spontaneous Abortions: Raymond W, Redline, MD, Michael Zaragoza, […]