Department / Division
Pathology / Pathology Clinical Services
Durham, NC 27710
919-286-0411, extension 6491
Immunopathology, transplantation, renal pathology
A major focus of both my clinical practice and investigative work is the diagnosis and treatment of disorders affecting solid-organ transplant recipients, particularly infectious complications. For the past 15 years, I have served as the primary pathologist for one of the largest lung transplant programs in the world; in the process contributing to over 20 peer-reviewed publications on complications of lung transplantation, including infections, gastroesophageal reflux, tumors, and antibody-mediated rejection; and writing a major book chapter on the subject (Howell DN and Palmer SM, Pathology of the Lung Transplant. 2006. In: Lynch JP, Ross D, eds. Lung and Heart-Lung Transplantation. Marcel Dekker, Inc., New York, pp. 683-722). I have also been the primary pathologist for Duke's renal and liver transplant programs, authoring or co-authoring a wide variety of journal articles and a book chapter in these areas (e.g., Plumb et al., Transplantation 2006;82:1224-1224; Snyder et al., Am. J. Respir. Crit. Care Med. 2010;181:1391-1396).
A second major area of interest is the pathogenesis of renal glomerular diseases. In collaboration with members of the Division of Nephrology at Duke, I have helped assemble and characterize a large registry of patients with familial focal segmental glomerulosclerosis (FFSGS)(Conlon et al., Kidney Int. 1999;56:1863-1871). Analysis of one of the families in this registry led to the discovery at Duke, in the laboratory of Dr. Michelle Winn, of mutations in the TRPC6 cation channel as a cause of FFSGS (Winn et al., Genomics 1999;58:113-120; Winn et al., Science 2005;308:1801-1804). We are continuing to collect data on additional families with focal segmental glomerulosclerosis. In addition, I have served as principle consultative pathologist for several investigators working in animal models of renal disease and transplantation (e.g., Crowley et al., Hypertension 2010;55:99-108).
Finally, I have devoted considerable time and energy to applications of correlative microscopy to diagnostic pathology, with particular emphasis electron microscopy. I am currently President of the Society for Ultrastructural Pathology, an international organization that promotes the use of ultrastructural examination in both diagnostic pathology and clinical and basic research. Much of my published work in this area involves the role of electron microscopy in the diagnosis of renal diseases (e.g., Howell et al., Ultrastruct. Pathol. 2003;17:295-312; Pavlisko and Howell, Ultrastruct. Pathol., in press), but I have also written extensively, with my colleague Dr. Sara Miller, on the ultrastructural diagnosis of infectious disorders, contributing, among other things, to the first description of a new polyomavirus-induced skin disorder, trichodysplasia spinulosa (Haycox et al., J. Investig. Dermatol. Symp. Proc. 1999;4:268-271).
This faculty member has no reported relationships with industry.
Crowley, SD; Frey, CW; Gould, SK; Griffiths, R; Ruiz, P; Burchette, JL; Howell, DN; Makhanova, N; Yan, M; Kim, HS; Tharaux, PL; Coffman, TM. Stimulation of lymphocyte responses by angiotensin II promotes kidney injury in hypertension. American Journal of Physiology: Renal Physiology. 2008;295:F515-F524. (2008) Abstract
Zafar, SY; Howell, DN; Gockerman, JP. Malignancy after solid organ transplantation: an overview. The Oncologist. 2008;13:769-778. (2008) Abstract
Plumb, TJ; Greenberg, A; Smith, SR; Butterly, DW; Pham, TT; Fields, TA; Howell, DN. Postinfectious glomerulonephritis in renal allograft recipients. Transplantation. 2006;82:1224-1228. (2006) Abstract
Fields, TA; McCall, SJ; Reams, BD; Roggli, VL; Palmer, SM; Howell, DN. Pulmonary embolization of microcrystalline cellulose in a lung transplant recipient. Journal of Heart and Lung Transplantation. 2005;24:624-627. (2005) Abstract
Naber, JM; Palmer, SM; Howell, DN. Cytomegalovirus infection presenting as bronchial polyps in lung transplant recipients. Journal of Heart and Lung Transplantation. 2005;24:2109-2113. (2005) Abstract
Turner, JW; Pien, BC; Ardoin, SA; Anderson, AM; Shieh, WJ; Zaki, SR; Bhatnagar, J; Guarner, J; Howell, DN; Woods, CW. A man with chest pain and glomerulonephritis. Lancet. 2005;365:2062. (2005) Abstract
Winn, MP; Conlon, PJ; Lynn, KL; Farrington, MK; Creazzo, T; Hawkins, AF; Daskalakis, N; Kwan, SY; Ebersviller, S; Burchette, JL; Pericak-Vance, MA; Howell, DN; Vance, JM; Rosenberg, PB. A mutation in the TRPC6 cation channel causes familial focal segmental glomerulosclerosis. Science. 2005;308:1801-1804. (2005) Abstract
Howell, DN; Gu, X; Herrera, GA. Organized deposits in the kidney and look-alikes. Ultrastructural Pathology. 2003;27:295-312. (2003) Abstract
King, JA; Culpepper, RM; Corey, GR; Tucker, JA; Lajoie, G; Howell, DN. Glomerulopathies with fibrillary deposits. Ultrastructural Pathology. 2000;24:15-21. (2000) Abstract
Nuckols, JD; Baron, PW; Stenzel, TT; Olatidoye, BA; Tuttle-Newhall, JE; Clavien, PA; Howell, DN. The pathology of liver-localized post-transplant lymphoproliferative disease: a report of three cases and a review of the literature. American Journal of Surgical Pathology. 2000;24:733-741. (2000) Abstract
Conlon, PJ; Lynn, K; Winn, MP; Quarles, LD; Bembe, ML; Pericak-Vance, M; Speer, M; Howell, DN. Spectrum of disease in familial focal and segmental glomerulosclerosis. Kidney International. 1999;56:1863-1871. (1999) Abstract
Howell, DN; Smith, SR; Butterly, DW; Klassen, PS; Krigman, HR; Burchette, JL; Miller, SE. Diagnosis and management of BK polyomavirus interstitial nephritis in renal transplant recipients. Transplantation. 1999;68:1279-1288. (1999) Abstract
Winn, MP; Alkhunaizi, AM; Bennett, WM; Garber, RL; Howell, DN; Butterly, DW; Conlon, PJ. Focal segmental glomerulosclerosis: a need for caution in live-related renal transplantation. American Journal of Kidney Diseases. 1999;33:970-974. (1999) Abstract
Winn, MP; Conlon, PJ; Lynn, KL; Howell, DN; Gross, DA; Rogala, AR; Smith, AH; Graham, FL; Bembe, M; Quarles, LD; Pericak-Vance, MA; Vance, JM. Clinical and genetic heterogeneity in familial focal segmental glomerulosclerosis. International Collaborative Group for the Study of Familial Focal Segmental Glomerulosclerosis. Kidney International. 1999;55:1241-1246. (1999) Abstract
Winn, MP; Conlon, PJ; Lynn, KL; Howell, DN; Slotterbeck, BD; Smith, AH; Graham, FL; Bembe, M; Quarles, LD; Pericak-Vance, MA; Vance, JM. Linkage of a gene causing familial focal segmental glomerulosclerosis to chromosome 11 and further evidence of genetic heterogeneity. Genomics. 1999;58:113-120. (1999) Abstract
Howell, DN; Payne, CM; Miller, SE; Shelburne, JD. Special techniques in diagnostic electron microscopy. Human Pathology. 1998;29:1339-1346. (1998) Abstract