Showing papers on "Fibrinoid necrosis published in 1983"

Analysis of vascular lesions in murine SLE. I. Association with serologic abnormalities.

Abstract: In murine SLE, two different vascular lesions can develop. A necrotizing polyarteritis (NPA), exclusively found in MRL/I mice, is characterized by a dense infiltration of PMN and fibrinoid necrosis of the arterial wall. The second, a degenerative vascular lesion, occurs in a low incidence in all SLE mice, except the (NZW X BXSB)F1 (WBF1) male, in which its incidence is 100%. This lesion shows subendothelial deposits of immunoglobulins with minimal or no inflammatory or proliferative reaction. This degenerative vascular disease (DVD) is predominantly localized in the coronary arteries and is highly correlated with myocardial infarction. Serologic analysis revealed that NPA in MRL/I mice was associated with relatively late development of high levels of autoantibodies and circulating immune complexes; DVD in WBF1 mice was associated with an early onset of autoantibody production of a low magnitude that gave rise to a persistent low level of circulating immune complexes. Characterization of circulating immune complexes in MRL/I mice showed these complexes were mainly of intermediate size (7S-19S) and contained predominantly anti-DNA antibodies. In WBF1 mice, complexes were barely detectable and contained mostly anti-gp70 antibodies. Elution of kidneys showed that the major antibody deposited in MRL/I mice has an anti-DNA specificity, whereas in WBF1 animals, the major antibody was anti-gp70. Furthermore, a 10 times greater amount of immunoglobulins could be eluted from WBF1 hearts with DVD than from MRL/I and BXSB hearts. Additionally, we found that the lack of an inflammatory reaction in DVD was not because of a preferential deposition of noncomplement-fixing IgG1 antibodies nor could it be related to a defective inflammatory response, because WBF1 mice had an undiminished reverse passive Arthus reaction throughout their lives. It is concluded that NPA develops secondary to high levels of autoantibodies with a concomitant rise in immune complexes, whereas DVD is associated with sustained low levels of circulating immune complexes.

Cerebrovascular diseases and their underlying vascular lesions in Hisayama, Japan--a pathological study of autopsy cases.

Abstract: Frequency of cerebrovascular diseases (CVD) and their underlying vascular lesions were analyzed in 724 autopsy cases, aged 40 years and over, in the community of Hisayama, Japan during the period 1961 to 1981. Cerebral infarction (CI) was more frequently found at autopsy than cerebral hemorrhage (CH) with a ratio of infarction and hemorrhage of 4.4. Small CI occupied 75.7% of the cases with CI. The cases with any type of CVD showed more severe atherosclerosis of the major cerebral arteries than did those without CI or CH. Cerebral atherosclerosis of those with large and medium CI was the greatest, and with decreasing severity in those with small CI and with CH sequentially. Fibrinoid necrosis of the intracerebral small arteries was frequently found in cases with hypertension and particularly associated with CH. The decline in frequency of CH was confirmed; however, changes in frequency of CI were not evident. Fibrinoid necrosis was also reduced, although the severity of cerebral atherosclerosis showed no definite change. The decline of CH seemed to be ascribed to the reduction of fibrinoid necrosis of the intracerebral small arteries.

Immune-mediated vasculitis in five dogs.

Abstract: Vasculitis was diagnosed in 5 dogs. Clinical signs varied, but all 5 dogs had signs of systemic illness. Inflammation and fibrinoid necrosis of small blood vessels were consistent findings. The skin and mucous membranes were the main tissues involved in 3 dogs; polyarthropathy and myopathy were diagnosed in 1 dog and myopathy in 1 dog. Good response to corticosteroid therapy was achieved in 3 dogs; in 2 dogs, immunosuppressive therapy with cyclophosphamide was necessary and the dogs responded well.

Electron microscopy of hypertensive pulmonary vascular disease

Abstract: Hypertensive pulmonary vascular disease secondary to chronic alveolar hypoxia is the result of vasoconstriction and then muscularization of the terminal portions of the pulmonary arterial tree. Ultrastructurally these two phases are characterized respectively by muscular evaginations and the hyperplasia of smooth muscle cells. Plexogenic pulmonary arteriopathy secondary to congenital cardiac shunts, primary pulmonary hypertension or rare cases of cirrhosis of the liver are characterized by concentric-laminar proliferation of myofibroblasts. Later there is a development of plexiform lesions which consist of vascular channels separated by a matrix of proteoglycan containing fibrillary cells and myofibroblasts. Fibrinoid necrosis results from the passage of fibrinogen from the vascular lumen into the arterial wall.

Avascular necrosis of bone with rheumatoid vasculitis.

Abstract: A 76-year-old woman with classical rheumatoid arthritis presented with a left groin mass associated with radiologic erosion of the adjacent bony public ramus. The hip joint was not involved. Computerized tomography showed an encapsulated cyst of the pubic ramus that was surgically excised and measured about 6 x 8 cm. Histologic examination of the cystic mass and adjacent bone showed marked avascular necrosis, surrounded by an acute necrotizing vasculitis with fibrinoid necrosis. We postulate that, in this case, rheumatoid vasculitis caused an avascular necrosis of the pubic ramus.

[Skin manifestations of Still's disease in adults. Apropos of 4 cases].

Abstract: The authors report four new cases of Still's disease in adult. Each time, the clinical picture associated the following triad: fever, joint involvement and skin rashes. The latter consisted in non-pruritic but sensitive maculo-papular and disseminated lesions, the mean course of which lasted 24 to 48 hours and were readily accompanied by the two other components of the basic clinical triad. Laboratory investigations were non-specific but constantly included a polymorphonuclear leucocytosis and a raised ESR, the mean value of which reached 80 mm in the 1st hour. Antinuclear factors were not demonstrated, but circulating immune complexes were found on several occasions in three out of the four reported cases. Histopathological changes observed were those of a superficial and mid cutis edema, associated with a diffuse or perivascular infiltrate in which either mononuclears or polymorphonuclears were prominent. Dermal vessels involvement appeared rather weak, including swelling of the walls by edema with focal fibrinoid necrosis. Direct immunofluorescence showed mainly IgG, IgA and C3 vascular deposits. Based on these data, an immune pathology is discussed, besides the more classic infections pathogenesis.

Intérêt du captopril dans le traitement d'une hypertension artérielle systémique et pulmonaire avec activité rénine plasmatique augmentée au cours d'une sclérodermie

Abstract: The effects of the converting enzyme inhibitor captopril (Lopril) were studied in a 53 year old woman with acute exacerbation of scleroderma. In addition to her chronic symptoms of Raynaud's syndrome, the patient presented with severe hypertension, cardiac failure and oligoanuria. Right heart catheterisation with a Swan-Ganz catheter confirmed the systemic hypertension with cardiac failure, and also demonstrated precapillary pulmonary hypertension with raised pulmonary arterial resistance. The organic renal failure was an indication for renal biopsy which showed segmental and focal fibrinoid necrosis with microthrombosis and chronic ischemic changes. Due to raised plasma renin activity, treatment with captopril was instituted, leading to a rapid normalisation of systemic and pulmonary hypertension, the regression of cardiac failure and a transient improvement in the Raynaud's syndrome. The renal failure did not improve and the patient had to undergo chronic hemodialysis. These spectacular initial results should be interpreted in the context of the poor prognosis of acute exacerbations of scleroderma despite the encouraging data published recently after well-controlled antihypertensive therapy.

[Effect of local injections of adriamycin on survival in malignant brain tumor: histopathological evaluation].

Abstract: Two long survival cases of primary malignant glioma are reported in terms of histopathological consideration comparing first surgical specimens with second surgical specimens followed by intraneoplastic local injection of Adriamycin (ADM). Case 1. A 56-year-old female was admitted to our hospital on October 24, 1977, with the complaints of headache and motor weakness on the left side of extremeties. Neurological examination revealed hemiparesis, homonymous hemianopsia and agnosia on the left side. Initial CT scan showed irregular high-density enhancing lesions in right parieto-occipital region with surrounding low-density area. Case 2. A 18-year-old male was admitted to our hospital on May 9, 1977, with the complaints of headache and nausea. Initial CT scan showed high-density enhancing resion in the left parieto-temporal region. In the microscopic findings of the recurrent tumor and surrounding necrotic tissue, there were massive coagulation necrosis of the tumor tissues and fibrinoid necrosis of vascular channels. In the surrounding area of the massive coagulation necrosis and small hemorrhages, there were many reactive collagenous tissues, increasing vascular channels, and infiltrating lymphocytes, granulocytes and foreign body giants cells, as well as so-called organized necrotic tissues. Residual tumor cells mainly composed of giant cells, gemistocytic astrocytes and spindle cells. The tumor was characteristic in that the tumor cells showed occasionally sarcomatous transformation in the other area. Some of anaplastic glial cells were positively stained for GFA protein in Case 1. Positive staining for GFA protain in the recurrent brain tumor are less than that of primary brain tumor. The cases were also discussed from the view point of pathology.

Renal vascular lesions in severe hypertension. Transitional changes from benign to malignant nephrosclerosis.

Abstract: Renal vascular changes In severe hypertension were studied. Twenty–five cases selected from 4,629 autopsies were classified into 2 groups according to the cause of death: group 1 (9 cases died of renal failure) and group 2 (16 cases of extra–renal death). Group 1 had been clinically diagnosed as malignant hypertension and had the hallmarks of malignant nephrosclerosis characterized by arteriolar fibrinoid necrosis and edematous intimal thickening. Group 2 had been clinically diagnosed as benign hypertension and basically exhibited the changes of benign nephrosclerosis. However, about half of the cases of group 2 had arteriolar fibrinoid necrosis, though the lesion was usually less extensive than in group 1. Immunofluorescence revealed similar deposits of immunoglobulins and fibrinogen in the site of fibrinoid necrosis observed in both groups. As for the changes of interlobular arteries, a quantitative analysis disclosed a distinctive difference between groups 1 and 2 with respect to the narrowing ratio of arterial lumina, though edematous intimal thickening was recognized on relatively rare occasions in the distal interlobular arteries to a few cases of group 2. From the results, the problem of transition from the benign to malignant nephrosclerosis was discussed. ACTA PATHOL. JPN. 33: 323–331, 1983.