Adams C W, Buk S J, Hughes R A, Leibowitz S, Sinclair E
Division of Histopathology, United Medical School, University of London, UK.
Neuropathol Appl Neurobiol. 1989 Sep-Oct;15(5):433-9. doi: 10.1111/j.1365-2990.1989.tb01244.x.
Preliminary observations suggested that arterial and arteriolar necrosis in vasculitis of the peripheral nerve leads to local haemorrhage and subsequent deposition of haemosiderin. This pigment is more readily recognized in the nerve by the sensitive Perls' test for iron than by relying on recognizing its yellow colour. To support the use of iron staining as an index of vasculitis, in addition to necrosis and fibrin deposition, we obtained the following results from nerve biopsy and autopsy nerve specimens: vasculitis confined to PNS = 5/6 iron positive; polyarteritis nodosa and Wegener's granulomatosis = 4/5 iron positive; systemic lupus erythematosus 2/3 iron positive; rheumatoid disease 1/1 iron positive; acute Guillain-Barré syndrome and subacute or chronic demyelinating polyradiculoneuropathy = 12/12 iron negative; and other perivascular inflammation in the PNS (without evidence of vasculitis) = 2/2 iron negative. One case of Churg-Strauss syndrome showed no changes on nerve biopsy. Iron staining was also demonstrated in the kidneys of five or six patients with polyarteritis nodosa.
初步观察表明，外周神经血管炎中的动脉和小动脉坏死会导致局部出血以及随后含铁血黄素的沉积。通过对铁敏感的普鲁士蓝染色法，这种色素在神经中比依靠识别其黄色更容易被识别。为了支持将铁染色作为血管炎的一个指标，除了坏死和纤维蛋白沉积外，我们从神经活检和尸检神经标本中获得了以下结果：局限于周围神经系统（PNS）的血管炎=6例中有5例铁染色阳性；结节性多动脉炎和韦格纳肉芽肿=5例中有4例铁染色阳性；系统性红斑狼疮3例中有2例铁染色阳性；类风湿病1例铁染色阳性；急性吉兰-巴雷综合征以及亚急性或慢性脱髓鞘性多发性神经根神经病=12例均铁染色阴性；PNS中的其他血管周围炎症（无血管炎证据）=2例均铁染色阴性。1例变应性肉芽肿性血管炎患者的神经活检未显示变化。五六例结节性多动脉炎患者的肾脏中也显示有铁染色。
