Clinical And Pathological Investigation Of Vasculitic Peripheral Neuropathy

Objective:Vasculitis peripheral neuropathy refers to the vascular occlusion of the peripheral nerve inflammation,resulting in one or more nerve infarction or ischemic disease. The disease can be found in a variety of vasculitis diseases,it may sometimes be the primary disease is the only clinical manifestations.In this study,10 cases of vascular peripheral neuropathy clinical and pathological features were analyzed retrospectively. Main purpose is to summarize different types of vasculitis of clinical and pathological features,to identify with other peripheral neuropathy and then to estimate the incidence of vasculitis peripheral neuropathy in china.Material and methods:We select 10 cases of the sural nerve specimens,diagnosed as pathological vasculitis peripheral neuropathy in the Pathology Laboratory of Shandong University Qilu Hospital Department of Neurology,staining in HE,MGT, immunohistochemistry,and so on.Some cases were stained by toluidine blue and observated in electronmicroscope.2 cases have the biceps brachii biopsy.Result:Epineurium and lamellar sheath shows vascular necrosis in 10 cases,the vessel wall intimal hyperplasia,lumen narrow and vascular occlusion.The inter-wall infiltration of inflammatory cells could be seen in the small blood vessels visible around.The small blood vessels is well in the endoneurium.Myelinated nerve fiber density and morphological changes:myelinated fiber obviously reduce in 4 cases,in which two cases have almost completely pulp loss,mild reduce in 6 cases,and that demyelinating change.SEM:there are axonal degeneration in the cases whose myelinated fiber loss,with secondary myelin destruction,and thin myelin fiber occasionally.8 cases were stained in immunohistochemistry.There were no immunoglobulin and complement deposition in the vessel wall with inflammation of all cases;CD3+,CD4+ and CD68+ is positive in all cases;CD8+ is positive in 7 cases;and CD20+ is positive in only 4 cases.Muscle biopsy were Typeâ…¡fibers shrink and small vessels inter-wall infiltration of inflammatory cells in two case.Conclusion:1.Non-systemic vasculitis neuropathy'ratio is 30 percents,which is the most, consistent with foreign literature.It suggests that non-systemic.vasculitis is the mainly type of vasculitis peripheral neuropathy in Chin2.Necrosis of arteries around the epineurium,the inter-wall infiltration of inflammatory cells and axonal degeneration is the specific features of vasculitis peripheral neuropathy.Muscle can also appear vascular inflammation,in accord with the nerve.3.T lymphocyte-mediation is a main factor of immune reactions of vasculitis peripheral neuropathy.