Loss of EPCR in the brain in CM and of TM in subcutaneous tissue. (A) Low-power (10× lens) view of postmortem brain samples shows vessels with moderate-to-strong staining for EPCR (immunoperoxidase method, arrows) in a non-CM control brain sample (left) and absence of EPCR staining in a vessel containing many sequestered IEs (arrow) in a CM case (right). (B) Association between IE sequestration, loss of EPCR, and fibrin deposition; upper image is a detail (40× lens) of the box in the bottom right of 2A and the lower image shows fibrin deposition (trichromic staining) in a consecutive tissue section. (C) EPCR staining is significantly reduced in CM compared with non-CM encephalopathic controls. The intensity of staining for EPCR was scored as none, weak, moderate (mod), or strong in 5 CM cases and 5 controls compared with reference images by the author and 2 independent pathologists. Datapoints are a combination of the data from all 3 scorers and indicate the percentage of vessels scored at each level in individual cases and bars the mean percentage of vessels scored at each level for the CM or non-CM group as a whole. (D) Subcutaneous tissue section in a fatal CM case. The red arrow indicates a vessel with high IE sequestration and minimal TM staining and the black arrow indicates a vessel with minimal IE sequestration and strong TM staining.