Brochet B, Louiset P, Lagueny A, Coquet M, Vital C, Loiseau P
Clinique Neurologique, Hôpital Pellegrin, Bordeaux.
Rev Neurol (Paris). 1988;144(10):590-5.
A 54 year-old woman presented with an asymmetrical polyneuropathy, with in addition signs of hepatitis and hypercalcemia. The diagnosis of sarcoidosis was made by hepatic and neuromuscular biopsies. Electrophysiological studies showed an asymmetrical clear neurogenic involvement with an axonal pattern. Ultrastructural study of the nerve showed sarcoid granulomas in epineurium, perineurium and endoneurium, with images of Wallerian degeneration. No features of primary demyelination were found. Granulomas were also present in muscle and liver. Possible etiological mechanisms are discussed: compression of nerve or vessels, or immune angiitis.
一名54岁女性出现不对称性多发性神经病,此外还有肝炎和高钙血症迹象。通过肝脏和神经肌肉活检确诊为结节病。电生理研究显示为不对称性明显的神经源性损害,呈轴索性。神经的超微结构研究显示,在神经外膜、神经束膜和神经内膜中有结节病肉芽肿,并伴有华勒变性图像。未发现原发性脱髓鞘的特征。肉芽肿也存在于肌肉和肝脏中。文中讨论了可能的病因机制:神经或血管受压,或免疫性血管炎。