血管炎性神经病：来自单一三级医疗中心的神经活检及临床特征回顾性分析
Vasculitic Neuropathy: A Retrospective Analysis of Nerve Biopsies and Clinical Features from a Single Tertiary Care Center.
作者信息
Hui Monalisa, Meena A K, Rajasekhar Liza, Sireesha Yareeda, Afshan Jabeen, Mridula Rukmini, Borgohain Rupam, Uppin Megha S
机构信息
Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
出版信息
Ann Indian Acad Neurol. 2019 Apr-Jun;22(2):180-186. doi: 10.4103/aian.AIAN_47_18.
OBJECTIVE
Vasculitic neuropathy can be either restricted to the peripheral nerves or associated with systemic involvement of other organs. The objective of this study was to analyze the nerve biopsies reported as "vasculitic neuropathy" with clinical features.
MATERIALS AND METHODS
All cases diagnosed with vasculitic neuropathy were retrospectively analyzed and categorized as systemic vasculitis and nonsystemic vasculitic neuropathy based on the clinical features. The histological features were further evaluated and classified according to the Peripheral Nerve Society Guidelines.
RESULTS
Of the 126 cases, there were 65 nonsystemic vasculitis, 45 secondary systemic vasculitis, and 16 primary systemic vasculitis. Definite vasculitis was more common in the systemic vasculitis group. The epineurial vessels were predominantly involved with chronic axonal changes.
CONCLUSION
The sensitivity of definite vasculitis on nerve biopsy was 54.76%. The sensitivity increases when the diagnostic criteria of definite and probable vasculitis were applied taking into account perivascular inflammation accompanied by vascular changes and axonopathy.
目的
血管炎性神经病可局限于周围神经，也可伴有其他器官的系统性受累。本研究的目的是分析报告为“血管炎性神经病”的神经活检及临床特征。
材料与方法
对所有诊断为血管炎性神经病的病例进行回顾性分析，并根据临床特征分为系统性血管炎和非系统性血管炎性神经病。根据周围神经学会指南进一步评估和分类组织学特征。
结果
126例病例中，非系统性血管炎65例，继发性系统性血管炎45例，原发性系统性血管炎16例。明确的血管炎在系统性血管炎组中更常见。神经外膜血管主要受累并伴有慢性轴突改变。
结论
神经活检中明确血管炎的敏感性为54.76%。当应用明确和可能血管炎的诊断标准，并考虑伴有血管改变和轴索性病变的血管周围炎症时，敏感性会增加。
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