Hrynchak M, Ang L C, Munoz D G
Department of Pathology, University Hospital Saskatoon, Saskatchewan, Canada.
Clin Neuropathol. 1992 Jan-Feb;11(1):45-8.
A 41-year old resident of a nursing home presented with bloody diarrhea, and subsequently developed hemolytic-uremic syndrome. E. coli serotype O157:H7 was isolated from the stool culture. At autopsy she was found to have bilateral symmetrical striatal necrosis involving mainly the putamen and lateral globus pallidus. The main microscopic findings consisted of coagulative necrosis, endothelial damage and microthrombosis. Scattered microscopic lesions of similar appearances were noted in the parietal cortex, external capsule and fornix. This case is of particular interest because of the rarity of bilateral striatal necrosis in hemolytic-uremic syndrome and the recent experimental data which implicate E. coli endotoxin in the pathogenesis of cerebral lesions in this syndrome.
一名41岁的养老院居民出现血性腹泻，随后发展为溶血尿毒综合征。从粪便培养物中分离出大肠杆菌O157:H7血清型。尸检发现她双侧对称性纹状体坏死，主要累及壳核和外侧苍白球。主要显微镜下表现为凝固性坏死、内皮损伤和微血栓形成。在顶叶皮质、外囊和穹窿中发现了散在的类似外观的微小病变。由于溶血尿毒综合征中双侧纹状体坏死罕见，且近期实验数据表明大肠杆菌内毒素与该综合征脑损伤的发病机制有关，因此该病例特别引人关注。
