Tsukada N, Koh C S, Owa M, Yanagisawa N
J Neurol Sci. 1983 Oct;61(2):193-210. doi: 10.1016/0022-510x(83)90005-9.
In 7 patients, including one autopsied case, with neuropathy associated with hepatitis B virus infection, histologic examination of sural nerve biopsies revealed small vessel vasculitis in the vasa nervorum. In all cases, immunofluorescent deposits of hepatitis B surface antigen, immunoglobulin and C3 complement were detected in the vasa nervorum. That these deposits could represent immune complexes composed of hepatitis B virus was supported by the serologic demonstration of high serum-level of immune complexes and by the ultrastructural demonstration of electron-dense deposits around the endoneural capillary and in the endoneurium. The densities of large myelinated fibers were significantly lower than controls (P less than 0.01) in 6 of 7 cases. These results suggest that immune complexes composed of hepatitis B virus might play a significant role in the pathogenesis of endoneural and epineural vascular lesions, through which neuropathy may be induced in patients with hepatitis B virus infection.
在7例（包括1例尸检病例）与乙型肝炎病毒感染相关的神经病变患者中，腓肠神经活检的组织学检查显示神经滋养血管存在小血管血管炎。在所有病例中，神经滋养血管中均检测到乙型肝炎表面抗原、免疫球蛋白和C3补体的免疫荧光沉积物。血清中高免疫复合物水平的血清学证据以及神经内膜毛细血管周围和神经内膜中电子致密沉积物的超微结构证据支持这些沉积物可能代表由乙型肝炎病毒组成的免疫复合物。7例中的6例，有髓大纤维密度显著低于对照组（P<0.01）。这些结果表明，由乙型肝炎病毒组成的免疫复合物可能在神经内膜和神经外膜血管病变的发病机制中起重要作用，通过这种机制，乙型肝炎病毒感染患者可能诱发神经病变。
