Hansen病の末梢神経障害 : 血管炎の立場からの考察  [in Japanese] Leprous neuropathy : Observation from the standpoint vasculitis :  [in Japanese]

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Abstract

Hansen病の末梢神経障害に血管炎が関与しているか、とすればどのようなタイプの血管炎か、そのpathogenesisはどのように考えたらよいのか、について血管炎の立場から1)血管炎症候群の分類、2)血管炎症候群と末梢神経障害、3)Hansen病の末梢神経障害と血管炎、の3項目について考察を試みる。

Pathogenesis of leprous neuropathy was studied from the standpoint of vasculitis. In vasculitic syndrome, mononeuritis multiplex is the most specific peripheral nerve injury. It ocurrs most frequently in small vessel vasculitis. Among them, the incidence is highest in microscopic polyangitis (MPO), Churg-Strauss Syndrome (CSS), and Wegener's granulomatosis (WG). All of them are categorized as ANCA associated disease. Because the disease activity is parallel with ANCA titer and ANCA is related directory to the pathogenesis of necrotizing vasculitis as well as the ocurrence of peripheral neuropathy. Other small vessel vasculitis, such as lupus or rhumatoid vasculitis which are believed to ocurr by immune complex mechanism, are accompanied seldom by periperal neuropathy. In WG, there are granulomatous lesions in upper and lower respiratory tracts which are supposed to be induced by Thl dominant CD4 T cell infiltration. In cases of leprosy, if peripheral neuropathy were related to small vessel vasculitis, there might be two different pathogenesis. One is granulomatous vasculitis like WG in tuberculoid type. The other is immune complex type necrotizing vasculitis like SLE in lepromatous type, especially ENL. The site of these events may be small vessel in epineurium. Further imunologic studies are needed to clarify detailed mechanisms of leprous neuropathy.

Journal

  • JAPANESE JOURNAL OF LEPROSY

    JAPANESE JOURNAL OF LEPROSY 68(2), 67-70, 1999-07-21

    Japanese Leprosy Association

References:  5

Cited by:  1

Codes

  • NII Article ID (NAID)
    10008625633
  • NII NACSIS-CAT ID (NCID)
    AN10559906
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    13423681
  • Data Source
    CJP  CJPref  J-STAGE 
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