Subject: polyarteritis nodosa/arthritis

   
   Neuropathol Appl Neurobiol 1989 Sep-Oct;15(5):433-9
   
Perls' ferrocyanide test for iron in the diagnosis of vasculitic neuropathy.

    Adams CW, Buk SJ, Hughes RA, Leibowitz S, Sinclair E
    
   Division of Histopathology, United Medical School, University of
   London, UK.
   
   Preliminary observations suggested that arterial and arteriolar
   necrosis in vasculitis of the peripheral nerve leads to local
   haemorrhage and subsequent deposition of haemosiderin. This pigment is
   more readily recognized in the nerve by the sensitive Perls' test for
   iron than by relying on recognizing its yellow colour. To support the
   use of iron staining as an index of vasculitis, in addition to
   necrosis and fibrin deposition, we obtained the following results from
   nerve biopsy and autopsy nerve specimens: vasculitis confined to PNS =
   5/6 iron positive; polyarteritis nodosa and Wegener's granulomatosis =
   4/5 iron positive; systemic lupus erythematosus 2/3 iron positive;
   rheumatoid disease 1/1 iron positive; acute Guillain-Barre syndrome
   and subacute or chronic demyelinating polyradiculoneuropathy = 12/12
   iron negative; and other perivascular inflammation in the PNS (without
   evidence of vasculitis) = 2/2 iron negative. One case of Churg-Strauss
   syndrome showed no changes on nerve biopsy. Iron staining was also
   demonstrated in the kidneys of five or six patients with polyarteritis
   nodosa.
   
   PMID: 2479878, UI: 90066970
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Subject: polyarteritis nodosa/arthritis

   
   Hum Pathol 1991 Dec;22(12):1187-94
   
Iron pigment deposits, small vessel vasculitis, and erythrophagocytosis in the
muscle of human immunodeficiency virus-infected patients.

    Gherardi RK, Mhiri C, Baudrimont M, Roullet E, Berry JP, Poirier J
    
   Departement de Pathologie (Neuropathologie), Hopital Henri Mondor,
   Creteil, France.
   
   Hemosiderin deposition and vascular inflammation were evaluated in
   muscle specimens from 50 human immunodeficiency virus (HIV)-infected
   individuals with neuromuscular symptoms. Iron deposits were detected
   in 25 of 50 cases, and were found more frequently in the distal
   muscles of lower limbs than in proximal muscles (22 of 30 cases v
   three of 20 cases; P less than .001). The incidence was higher than in
   controls (P less than .01). Polyarteritis nodosa was observed in three
   cases and microvascular inflammation was observed in 27. Direct
   immunofluorescence showed deposits of both immunoglobulins (mainly
   immunoglobulin M) and complement in small vessel walls of 19 of 34
   patients. The p17 and p24 HIV antigens were detected in three of 27
   cases. Both T8 lymphocytes and macrophages were significantly more
   numerous in patients with Perls'-positive material; these patients
   also showed vascular inflammation more frequently. Other findings
   included noninflammatory microangiopathy (18 cases), tubuloreticular
   inclusions in endothelial cells (one case), and free and
   intracytoplasmic eosinophilic globules likely representing digested
   erythrocytes (seven cases). The present study shows that iron pigment
   deposition in skeletal muscle is a nonspecific finding, frequently
   observed in the lower extremities of HIV-infected individuals, where
   it reflects immunopathologic alterations of the microcirculation.
   Erythrophagocytosis, which may be observed in the muscle of some
   HIV-infected individuals, may also be implicated.
   
   PMID: 1748426, UI: 92084311
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