Jeruc Jera, Popovic Mara, Vizjak Alenka, Jurcić Vesna, Lestan Boris, Ferluga Dusan
Institute of Pathology, Faculty of Medicine, Ljubljana, Korytkova 2, SI-1000 Ljubljana, Slovenia.
Folia Neuropathol. 2006;44(2):140-3.
This report illustrates a case of peripheral nerve vasculitis associated with elevated anticardiolipin antibodies. A 49-year-old female with a history of seven spontaneous abortions initially complained of pain and numbness in her right calf that later spread to the left foot and ankle. Over the next few months, she developed a Raynaud phenomenon and livedo reticularis. Clinical examination revealed signs of multiple mononeuropathy. Right sural nerve biopsy performed two months after the beginning of the disease revealed active necrotizing arteritis of the epineural arteries with transmural inflammatory infiltrate and thrombosis. Vasculitis is a rare finding in sural nerve biopsies, usually in patients with systemic vasculitis or autoimmune connective tissue diseases. However, vasculitis restricted to the peripheral nerves has also been described. Our patient had no clinical or laboratory features of any autoimmune disorder and also no signs of systemic vasculitis. We discuss the potential role of anticardiolipin antibodies in the pathogenesis of vasculitis.
本报告阐述了一例与抗心磷脂抗体升高相关的周围神经血管炎病例。一名有7次自然流产史的49岁女性最初主诉右小腿疼痛和麻木，随后蔓延至左脚和脚踝。在接下来的几个月里，她出现了雷诺现象和网状青斑。临床检查发现有多发性单神经病的体征。疾病开始两个月后进行的右腓肠神经活检显示，神经外膜动脉有活动性坏死性动脉炎，伴有透壁性炎症浸润和血栓形成。血管炎在腓肠神经活检中是罕见发现，通常见于患有系统性血管炎或自身免疫性结缔组织病的患者。然而，也有局限于周围神经的血管炎的相关描述。我们的患者没有任何自身免疫性疾病的临床或实验室特征，也没有系统性血管炎的体征。我们讨论了抗心磷脂抗体在血管炎发病机制中的潜在作用。
