Nascimento O J, De Freitas M R, Chimelli L
Département de Médecine Clinique (Neurologie), Hôpital Universitaire Antonio Pedro, Université Fédérale Fluminense, Niterói-RJ, Brésil.
Rev Neurol (Paris). 1991;147(10):679-81.
We report the case of a 44-year-old woman presenting with chronic symmetrical, sensitive polyneuropathy on the lower limbs in the course of Chagas' disease. The electrophysiological findings were in keeping with axonal degeneration. The histological data displayed axonal degeneration with perivascular inflammatory mononuclear cells in the epineurium, with some neutrophils and eosinophils. Mononuclear cells surrounding endoneurial vessels were observed. Laboratory data did not suggest neither a mixed connective tissue disease nor a collagen vascular disorder. Hematological disease, malignancies, drug-or medicine-induced neuropathy were ruled out. The polyneuropathy in this case was probably related to Trypanosoma cruzi infection on account of the presence of high levels of anti-T. cruzi antibodies, and an immune mechanism might play a role in the vasculitic process.
我们报告了一例44岁女性病例,该患者在恰加斯病病程中出现慢性对称性、下肢感觉性多神经病。电生理检查结果符合轴索性变性。组织学数据显示轴索性变性,神经外膜有血管周围炎性单核细胞,伴有一些中性粒细胞和嗜酸性粒细胞。观察到神经内膜血管周围有单核细胞。实验室数据未提示混合性结缔组织病或胶原血管病。血液系统疾病、恶性肿瘤、药物或药物性神经病均被排除。鉴于存在高水平的抗克氏锥虫抗体,该病例中的多神经病可能与克氏锥虫感染有关,免疫机制可能在血管炎过程中起作用。