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[球形细胞白质营养不良(克拉伯病)。周围神经病变(作者译)]

[Globoid cell leucodystrophy (Krabbe's disease). Peripheral nerve lesion (author's transl)].

作者信息

Martin J J, Ceuterick C, Martin L, Leroy J G, Nuyts J P, Joris C

出版信息

Acta Neurol Belg. 1974 Nov-Dec;74(6):356-75.

PMID:4377697
Abstract

Morphological study of peripheral nerves in two patients with globoid cell leucodystrophy (Krabbe's disease) demonstrates: 1degree segmentary demyelination; 2degrees marked loss of large (8-10 micra) myelinated fibres; 3degrees significant increase of the mean transverse fascicular area by proliferating collagen fibres; 4degrees electron-microscopic signs of remyelination with small onion-bulb formations. These findings can explain clinical features such as the disappearance of the deep tendon reflexes, the gradual transition of hypertonia into combined hypertonia-hypotonia and the concomitant slowing of nerve conduction velocity. The ultrastructural study reveals the presence of large and small inclusions which are either located within lysosomes or free in the cytoplasm of Schwann cells and fibroblasts. The inclusions are probably consequences of the disturbed metabolism of cerebrosides. Their appearance is sufficiently specific in order to allow a diagnosis of Krabbe's disease.

摘要

对两名球形细胞脑白质营养不良(克拉伯病)患者外周神经的形态学研究表明:1级节段性脱髓鞘;2级大的(8 - 10微米)有髓纤维显著丧失;3级增生的胶原纤维使平均横束面积显著增加;4级有小洋葱球形成的再髓鞘化的电镜征象。这些发现可以解释诸如深部腱反射消失、张力亢进逐渐转变为张力亢进与张力减退并存以及神经传导速度随之减慢等临床特征。超微结构研究显示存在大小不等的包涵体,它们要么位于溶酶体内,要么游离于施万细胞和成纤维细胞的细胞质中。这些包涵体可能是脑苷脂代谢紊乱的结果。它们的外观具有足够的特异性,以便能够诊断克拉伯病。

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