Scola R H, Werneck L C, Iwamoto F M, de Messias I T, Tsuchiya L V
Departamento de Clínica Médica do Hospital de Clínicas da Universidade Federal do Paraná (UFPR), Brasil.
Arq Neuropsiquiatr. 1998 Sep;56(3A):388-97. doi: 10.1590/s0004-282x1998000300007.
Among 1400 muscle biopsies, we found 16 cases with rimmed vacuoles whose diagnosis were sporadic inclusion body myositis (IBM) (4 cases), juvenile spinal muscular atrophy (6 cases), distal myopathies (3 cases), limb-girdle muscular dystrophy (2 cases), and peripheral neuropathy (1 case). Monoclonal antibodies reactive for T lymphocytes and subsets, B lymphocytes, macrophages, natural killer cells, immunoglobulins, and complement were used to analyze the inflammatory infiltrate. The analysis was quantitative and according to the site of accumulation (interstitial, endomysial, and perivascular). The immunocytochemical analysis showed CD8+ lymphocytes in the interstitial in most cases, occasionally inside of muscle fibers, and rarely in the perivascular region. The IBM cases had an increased number of CD8+ lymphocytes comparing with the other diseases. CD8+/CD4+ ratio was increased in IBM compared with the other diseases. Macrophages were frequent in IBM, distal myopathy, and one case of limb-girdle muscular dystrophy. Natural killer cells were frequent at interstitial.
在1400例肌肉活检中,我们发现16例有镶边空泡,其诊断分别为散发性包涵体肌炎(IBM)(4例)、青少年脊髓性肌萎缩症(6例)、远端肌病(3例)、肢带型肌营养不良症(2例)和周围神经病(1例)。使用针对T淋巴细胞及其亚群、B淋巴细胞、巨噬细胞、自然杀伤细胞、免疫球蛋白和补体的单克隆抗体来分析炎性浸润。分析是定量的,并根据积聚部位(间质、肌内膜和血管周围)进行。免疫细胞化学分析显示,大多数情况下间质中有CD8+淋巴细胞,偶尔在肌纤维内部,很少在血管周围区域。与其他疾病相比,IBM病例中CD8+淋巴细胞数量增加。与其他疾病相比,IBM中CD8+/CD4+比值升高。巨噬细胞在IBM、远端肌病和1例肢带型肌营养不良症中很常见。自然杀伤细胞在间质中很常见。