Physicians

Department / Division
Pathology / Pathology Clinical Services

Address
DUMC 3712
Durham, NC 27710

Office Telephone
919-286-0411, ext. 6491

Fax Telephone
919-286-6893

Training

• MD, Duke University School of Medicine, 1984

Residency

• Pathology, Duke University Medical Center, 1984-1987

Other Training

• 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 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).

Industry Relationships and Collaborations (What's this?)

This physician has no reported relationships with industry.

Representative Publications
Alexander BD, Schell WA, Siston AM, Rao CY, Bower WA, Balajee SA, Howell DN, Moore ZS, Noble-Wang J, Rhyne JA, Fleischauer AT, Maillard JM, Kuehnert M, Vikraman D, Collins BH, Marroquin CE, Park BJ. Fatal Apophysomyces elegans Infection Transmitted by Deceased Donor Renal Allografts. Am J Transplant. 2010 Aug 25. (2010) Abstract

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. Am J Physiol Renal Physiol. 2008 Aug;295(2):F515-24. (2008) Abstract

Zafar SY, Howell DN, Gockerman JP. Malignancy after solid organ transplantation: an overview. Oncologist. 2008 Jul;13(7):769-78. (2008) Abstract

Plumb TJ, Greenberg A, Smith SR, Butterly DW, Pham TT, Fields TA, Howell DN. Postinfectious glomerulonephritis in renal allograft recipients.  Transplantation.  2006 Nov 15;82(9):1224-8. (2006) Abstract

Fields TA, McCall SJ, Reams BD, Roggli VL, Palmer SM, Howell DN. Pulmonary embolization of microcrystalline cellulose in a lung transplant recipient.  J Heart Lung Transplant.  2005 May;24(5):624-7. (2005) Abstract

Naber JM, Palmer SM, Howell DN. Cytomegalovirus infection presenting as bronchial polyps in lung transplant recipients. J Heart Lung Transplant. 2005 Dec;24(12):2109-13. (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 Jun 11-17;365(9476):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 Jun 17;308(5729):1801-4. (2005) Abstract

Howell DN, Gu X, Herrera GA. Organized deposits in the kidney and look-alikes. Ultrastruct Pathol. 2003 Sep-Oct;27(5):295-312. (2003) 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

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

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, 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

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. Am J Kidney Dis. 1999 May;33(5):970-4. (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 Int. 1999 Apr;55(4):1241-6. (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 Jun 1;58(2):113-20. (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