血管炎性ニューロパチーの臨床病理学的検討(神経内科学教室竹宮敏子教授退任記念特別号)

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Vasculitic neuropathy is associated with various pathologic processes. We have reviewed the clinical and histopathologic characteristics of sural nerve biopsy and muscle biopsy in cases with peripheral neuropathy associated with connective tissue diseases and related disorders in whom sural nerve biopsy was obtained or in cases with necrotizing vasculitis in sural nerve biopsy. These patients consisted of four cases of polyarteritis nodosa (PN), two systemic lupus erythematosus (SLE), two rheumatoid arthritis (RA), one Hashimoto disease, one non systemic vasculitic neuropathy, and one hypereosinophilia. The clinical characteristics of peripheral neuropathy of these cases were as follows; (1) Duration from the onset of the disease and peripheral neuropathy was shorter in PN. (2) Symptoms such as dysesthesia, pain and edema in the extremities were common features in most of the patients. (3) Clinical examination and a nerve conduction study showed the distribution of neuropathy was of multiple mononeuropathy. (4) A motor and sensory nerve conduction study revealed markedly reduced action potentials without slowing of conduction velocity often resulting in absent recordings. (5) Cranial nerves were rarely involved. (6) Sural nerve biopsy revealed marked decrease in myelinated fiber density and active axonal degeneration with relatively well-preserved unmyelinated fibers. (7) Muscle biopsy showed mainly neurogenic changes with some degree of myogenic changes and occasional association with type 2 fiber atrophy.
東京女子医科大学の論文
2000-12-30

血管炎性ニューロパチーの臨床病理学的検討(神経内科学教室竹宮敏子教授退任記念特別号)

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