Fishbein Gregory A, Micheletti Robert G, Currier Judith S, Singer Elyse, Fishbein Michael C
Division of Anatomic Pathology, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
Cardiovasc Pathol. 2008 Mar-Apr;17(2):117-23. doi: 10.1016/j.carpath.2007.07.002. Epub 2007 Sep 12.
Systemic oxalosis may be hereditary or acquired. In these cases, calcium oxalate deposits have been reported in numerous tissues, including the media of arteries. In any category, calcium oxalate deposition has not been described within atherosclerotic plaques in any arteries.
As part of a retrospective clinicopathologic study, 80 hearts were obtained from the National Neurological AIDS Bank in an effort to study coronary atherosclerosis in patients infected with HIV. The population consisted of 66 HIV-positive and 14 HIV-negative patients with an average age of 47 years; 79% were males. Proximal coronary arteries were serially sectioned and processed routinely. Sections were studied by hematoxylin and eosin staining and, in selected cases, von Kossa stain and alizarin red S under different conditions, including polarized light, to allow distinction of calcium phosphate from calcium oxalate. Medical histories, autopsy reports, and general autopsy slides were reviewed.
In four patients (three with AIDS), calcium oxalate crystals were observed within atherosclerotic plaques in the coronary arteries. Similar deposits were seen in the thyroid gland and other organs but not in the kidneys. None of the patients had chronic renal failure.
The calcium oxalate crystal deposits observed in the atherosclerotic plaques in the coronary arteries of these four patients are unique in two ways: (a) these deposits have not previously been described in atherosclerotic plaques; (b) the patients did not demonstrate any of the recognized patterns of oxalosis. We suggest the phrase "atherosclerotic oxalosis" to describe this finding.
系统性草酸沉积症可能是遗传性的或后天获得的。在这些病例中，草酸钙沉积已在包括动脉中层在内的众多组织中被报道。在任何类别中，尚未在任何动脉的动脉粥样硬化斑块内描述过草酸钙沉积。
作为一项回顾性临床病理研究的一部分，从国家神经艾滋病库获取了80颗心脏，以研究感染HIV患者的冠状动脉粥样硬化。该人群包括66名HIV阳性和14名HIV阴性患者，平均年龄47岁；79%为男性。对近端冠状动脉进行连续切片并常规处理。切片用苏木精和伊红染色进行研究，在选定病例中，在不同条件下（包括偏振光）用冯·科萨染色和茜素红S染色，以区分磷酸钙和草酸钙。回顾了病史、尸检报告和一般尸检切片。
在4例患者（3例患有艾滋病）的冠状动脉粥样硬化斑块内观察到草酸钙晶体。在甲状腺和其他器官中也发现了类似的沉积物，但在肾脏中未发现。所有患者均无慢性肾衰竭。
在这4例患者冠状动脉粥样硬化斑块中观察到的草酸钙晶体沉积物在两个方面是独特的：（a）这些沉积物以前未在动脉粥样硬化斑块中被描述过；（b）患者未表现出任何已确认的草酸沉积症模式。我们建议用“动脉粥样硬化性草酸沉积症”来描述这一发现。
