Krendel D A, Parks H P, Anthony D C, St Clair M B, Graham D G
Department of Internal Medicine, Duke University Medical Center, Durham, NC 27710.
Muscle Nerve. 1989 Apr;12(4):257-64. doi: 10.1002/mus.880120402.
We compared histologic features of sural nerve biopsies in 14 patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) with those in other forms of neuropathy. In CIDP endoneurial pericapillary cellular infiltrates were found in 4 patients (29%), onion bulbs in 5 patients (36%), and predominant demyelination in 7 patients (50%). None of these abnormalities was specific, but cellular infiltrates and onion bulbs appear to be diagnostically useful when combined with clinical information. To detect macrophage infiltration of myelin, cell nuclei were counter-stained in 20 teased fiber preparations. Nine patients with CIDP had a significantly higher mean number of cells per centimeter of teased fiber than 11 patients with other neuropathies. Despite overlap, significant infiltration of myelin detected by this method suggests CIDP in an appropriate clinical setting.
我们比较了14例慢性炎性脱髓鞘性多发性神经根神经病（CIDP）患者与其他形式神经病患者的腓肠神经活检组织学特征。在CIDP患者中，4例（29%）发现神经内膜毛细血管周围细胞浸润，5例（36%）发现洋葱球样结构，7例（50%）发现以脱髓鞘为主。这些异常均无特异性，但细胞浸润和洋葱球样结构与临床信息相结合时似乎对诊断有帮助。为检测髓鞘的巨噬细胞浸润，在20份 teased fiber 标本中对细胞核进行复染。9例CIDP患者每厘米 teased fiber 的平均细胞数显著高于11例其他神经病患者。尽管存在重叠，但通过该方法检测到的髓鞘显著浸润在适当的临床背景下提示CIDP。
