David N. Howell, MD, PhD

Department / Division:
Pathology

Address:
DUMC 3712
Durham, NC 27710

Office Telephone:
919-286-0411, ext. 6491

Fax Telephone:
919-286-6818

• MD, Duke University School of Medicine, 1984

• Pathology, Duke University Medical Center, 1984-1987

• PhD, Immunology, Duke University Medical Center, 1982

Clinical Interests:
Immunopathology, transplantation, renal pathology

Research Interests:
A major focus of both my clinical practice and investigative work is the application of correlative microscopy to diagnostic pathology, with particular emphasis on techniques such as laser scanning confocal microscopy and electron microscopy.  We have developed a method in which confocal microscopy is used as a survey tool to identify focal pathologic processes for subsequent ultarstructural study, and used this technique to facilitate the first published study of the ultrastructural pathology of human flavivirus encephalitis (Chu et al., Am. J. Surg. Pathol. 1999;23:1217-1226).  Reviews and methodological details pertaining to this work are provided in a journal article (Howell et al., Hum. Pathol. 1998;29:1339-1346) and chapters in two books.

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 the largest extant registry of patients with familial focal segmental glomerulosclerosis.  Five papers describing clinical, pathological, and molecular genetic studies on these patients have been published; one describes the mapping of the defective gene in one large family to a region of chromosome 11.  In addition, an NIH-RO1 proposal on this subject, in which I am a participant, has been funded.  We are continuing to collect data on additional families with focal segmental glomerulosclerosis.

A final area of interest is the diagnosis and treatment of disorders affecting transplant recipients, particularly infectious complications.  Recent publications have included reports on BK polyomavirus infections in renal transplant recipients (Howell et al., Transplantation 1999;68:1279-1288) and post-transplant lymphoproliferative disorder in liver (Nuckols et al., Am. J. Surg. Pathol. 2000;24:733-741) and lung (Reams et al., Chest 2003;124:1242-1249) transplant recipients.  I have also co-authored eleven additional peer-reviewed publications on complications of lung transplantation, including infections, gastroesophageal reflux, and antibody-mediated rejection.

Representative Publications:
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. Am J Surg Pathol. 2000 May;24(5):733-41. (2000) Abstract

King JA, Culpepper RM, Corey GR, Tucker JA, Lajoie G, Howell DN. Glomerulopathies with fibrillary deposits. Ultrastruct Pathol. 2000 Jan-Feb;24(1):15-21. (2000) Abstract

Howell DN, Smith SR, Butterly DW, Klassen PS, Krigman HR, Burchette JL Jr, Miller SE. Diagnosis and management of BK polyomavirus interstitial nephritis in renal transplant recipients. Transplantation. 1999 Nov 15;68(9):1279-88. (1999) 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 Int. 1999 Nov;56(5):1863-71. (1999) Abstract

Howell DN, Payne CM, Miller SE, Shelburne JD. Special techniques in diagnostic electron microscopy. Hum Pathol. 1998 Dec;29(12):1339-46. (1998) Abstract