Steininger H, Langer E, Stömmer P
Pathologisches Institut, Universität Erlangen-Nürnberg.
Dtsch Med Wochenschr. 1990 Apr 27;115(17):657-62. doi: 10.1055/s-2008-1065062.
For many years a 52-year-old patient suffering from duodenal ulcer had taken a silver-containing preparation, the total quantity of silver ingested in this manner amounting to about 35 g. 18 years after the first manifestation of duodenal ulcer a dermatologist diagnosed argyria and confirmed this by biopsy. After acute coronary failure with marked nicotine abuse autopsy revealed granulated deposits of silver in the corium, particularly on elastic fibres, at the sweat glands, sebaceous glands and hair follicles. There were no deposits in the epidermis. Dense silver deposits were also seen in the walls of most of the blood vessels, in the basal membranes of the renal glomeruli, of the choroid plexus and of the seminiferous tubules, as well as in the portal fields. Definite intracellular deposits occurred in macrophages only. The metal was found only rarely in epithelial basal membranes. Generalised argyria does not entail any pathological implications and is considered to be intractable.
多年来，一名患有十二指肠溃疡的52岁患者一直服用含银制剂，以这种方式摄入的银总量约为35克。十二指肠溃疡首次出现18年后，一名皮肤科医生诊断出银质沉着病，并通过活检予以证实。在因严重尼古丁滥用导致急性冠状动脉衰竭后进行的尸检显示，真皮中有颗粒状银沉积物，尤其是在弹性纤维上、汗腺、皮脂腺和毛囊处。表皮中没有沉积物。在大多数血管壁、肾小球基底膜、脉络丛和生精小管的基底膜以及门管区也可见致密的银沉积物。仅在巨噬细胞中出现明确的细胞内沉积物。该金属仅在上皮基底膜中很少发现。全身性银质沉着病没有任何病理影响，被认为是难以治愈的。
