Calore E E, Shulte G, Penalva De Oliveira A C, Cavaliere M J, Perez Calore N M, Weg R
Department of Pathology, Emilio Ribas Institute, Sao Paulo, Brazil.
Pathologica. 1998 Feb;90(1):31-5.
Patients with AIDS can present clinical involvement of the peripheral nervous system due to different causes. In the present work, it was studied the histopathological changes in sural nerve biopsy of fifteen patients with AIDS with this clinical involvement. It was observed the presence of a polyarteritis nodosa-like vasculitis of small arteries with fibrinoid necrosis in the sural nerve of 3 patients, one of them associated to polyradiculitis due to cytomegalovirus infection (CMV). Six patients presented mild axonal loss by light microscopy. Three other patients had a more important axonal neuropathy with myelin ovoids by teasing. By the electron microscopy in these patients were observed some fibers with axonal damage. The other three patients had normal sural nerves. We concluded that sural nerve biopsy may be important in peripheral neuropathies or myelo-radiculo-polyneuropathies in AIDS especially to search for nerve vasculitis, because it can change the therapeutic approach.
艾滋病患者可能因不同原因出现周围神经系统的临床受累。在本研究中，对15例有这种临床受累表现的艾滋病患者的腓肠神经活检组织病理学变化进行了研究。在3例患者的腓肠神经中观察到小动脉的结节性多动脉炎样血管炎伴纤维素样坏死，其中1例与巨细胞病毒（CMV）感染所致的多发性神经根炎有关。6例患者通过光学显微镜检查显示轻度轴突丧失。另外3例患者经分离检查显示有更严重的轴突神经病伴髓鞘样小体。通过电子显微镜检查，在这些患者中观察到一些有轴突损伤的纤维。其他3例患者的腓肠神经正常。我们得出结论，腓肠神经活检对于艾滋病患者的周围神经病或脊髓神经根多神经病可能很重要，特别是用于寻找神经血管炎，因为它可能改变治疗方法。
