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[颞浅动脉活检的直接免疫荧光检查有价值吗?101例活检研究结果]

[Does the direct immunofluorescence examination of superficial temporal artery biopsies have any value? Results of the study of 101 biopsies].

作者信息

Touchard G, Debiais P, Gouet D, Babin P, Payen J

出版信息

Ann Pathol. 1984 Apr-May;4(2):115-21.

PMID:6375688
Abstract

The lesions in temporal arteritis (TA) are known to be often segmental and the pathologic study of involved temporal arteries may be falsely negative. Several reports suggest that direct immunofluorescence (IF) may be of value in the diagnosis of the disease. We have studied by IF 101 consecutive biopsies from 100 patients investigated during the last two years. Adjacent segments were processed for light and immunofluorescent microscopy. For the latter, tissues were immediately frozen in liquid nitrogen and stored at -- 70 degrees C. Cryostat sections were stained with anti-gamma, alpha, mu, C3, fibrinogen and albumin conjugates. A sister section was also stained with HE for light microscopy. Deposits of Ig and/or C were either granular (intra- or extra-cellular) or linear closely applied to internal elastic lamina. The 100 patients fall into 4 groups: Group I, (19 patients) with diagnosis ascertained upon typical clinical record and clear cut anatomic lesions by light microscopy; Group II (10 patients) with the clinical features of TA and a negative biopsy by light microscopy; Group III (29 patients) in whom the diagnostic criteria of polymyalgia rheumatica were fulfilled according to Forestier and Certonciny; Group IV (42 patients) affected with various diseases unrelated to T.A. (1 with polyarteritis nodosa, 5 with rheumatoid arthritis...). The following results were obtained by IF: in group I, deposits were found in 63% of the patients studied (linear in 11 and granular in 4 cases). They included Ig usually with C3 and fibrinogen. In group II, we observed linear deposits of IgG in one patient and granular C3 deposits in another case.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

颞动脉炎(TA)的病变通常呈节段性,对受累颞动脉的病理研究可能出现假阴性结果。有几份报告表明,直接免疫荧光(IF)在该病的诊断中可能具有价值。在过去两年中,我们对100例患者的101次连续活检进行了IF研究。相邻节段进行了光镜和免疫荧光显微镜检查。对于后者,组织立即在液氮中冷冻,并储存在-70摄氏度。冰冻切片用抗γ、α、μ、C3、纤维蛋白原和白蛋白结合物染色。另一个姐妹切片也用苏木精-伊红(HE)染色用于光镜检查。免疫球蛋白(Ig)和/或补体(C)的沉积要么是颗粒状(细胞内或细胞外),要么是紧密附着于内弹力层的线性沉积。100例患者分为4组:第一组(19例),根据典型临床记录和光镜下明确的解剖病变确诊;第二组(10例),具有TA的临床特征,但光镜活检为阴性;第三组(29例),根据福雷斯蒂埃和塞尔托尼西的标准符合风湿性多肌痛的诊断标准;第四组(42例),患有与TA无关的各种疾病(1例结节性多动脉炎,5例类风湿关节炎……)。IF检查结果如下:在第一组中,63%的研究患者发现有沉积物(11例为线性,4例为颗粒状)。沉积物通常包括Ig以及C3和纤维蛋白原。在第二组中,我们观察到1例患者有IgG线性沉积,另1例有颗粒状C3沉积。(摘要截取自250字)

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