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[特殊类型肝性脑病一例脑内铁沉积]

[Iron deposition in the brain of a case of the special type of hepatocerebral encephalopathy].

作者信息

Saito A, Amano N, Yokoi S, Akagi M, Izeki E, Arai N, Ikemi Y

机构信息

Kanagawa Prefectural Hospital, Yokohama, Japan.

出版信息

No To Shinkei. 1989 May;41(5):493-9.

PMID:2803822
Abstract

The histochemical demonstration of iron and the iron content was examined in the brain of a case of the special type of hepatocerebral encephalopathy (HCE). The patient had suffered from a liver disease since 36 years old. At 44 years old, she experienced the first attack of twilight state with flapping tremor. She had predilection for eating beans. Her personality gradually became euphoric with the recurrent episodes of unconsciousness. At 54 years old, she died of the complication of melena, renal insufficiency and pneumonia. The liver showed cirrhotic changes and iron content of liver was 0 or 1 after MacDonald's criterion scale. The histopathological findings of the brain showed the characteristic changes of HCE, which were incomplete softening and spongy state pseudolaminarilly extending in the deep layer of the cerebral cortex, the proliferation of the severely changed Alzheimer 2 type glia with or without intranuclear carmine positive substance. The deparaffinized sections, 20 mu in thickness, which were not fastened on slides were used for the histochemical study of iron, because iron deposits displaced inside of the brain tissues when the paraffin sections were fastened on slide glasses in the constant-temperature bath. The iron deposition was found in the central gyrus, superior temporal gyrus, medial and lateral occipito-temporal gyrus and middle temporal gyrus of occipital lobe. The iron accumulated in the ground substance, glia cell bodies, glia nuclei and unknown bodies in the 3-6 layers of cerebral cortex of these gyri. The iron accumulation demonstrated histochemically in other parts of the brain were group 1, 2 by Spatz, mammillary body, glia cell bodies in cerebellar white matter and pons.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对一例特殊类型的肝性脑病(HCE)患者的大脑进行了铁的组织化学显示及铁含量检测。该患者自36岁起患有肝脏疾病。44岁时,她首次出现伴有扑翼样震颤的朦胧状态发作。她偏好食用豆类。随着意识丧失反复发作,其性格逐渐变得欣快。54岁时,她死于黑便、肾功能不全和肺炎并发症。肝脏呈现肝硬化改变,根据麦克唐纳标准量表,肝脏铁含量为0或1。大脑的组织病理学检查结果显示出HCE的特征性变化,即大脑皮质深层不完全软化和假层状海绵样状态,严重改变的阿尔茨海默2型胶质细胞增生,有或无核内胭脂红阳性物质。用于铁组织化学研究的是厚度为20微米、未贴在载玻片上的脱石蜡切片,因为当石蜡切片在恒温浴中贴在载玻片上时,脑组织内的铁沉积物会移位。在中央回、颞上回、枕颞内侧和外侧回以及枕叶颞中回发现了铁沉积。铁在这些脑回的大脑皮质3 - 6层的基质、胶质细胞体、胶质细胞核和不明物体中蓄积。大脑其他部位经组织化学显示的铁蓄积部位为斯帕茨分类的1、2组、乳头体、小脑白质和脑桥中的胶质细胞体。(摘要截断于250字)

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