Biopsia muscular em miastenia grave: estudo histoquímico e morfométrico de 4 casos

Stavale, João Norberto; Cavaliere, Maria José; Gagioti, Sonia Maria; Atalla, Açucena; Guidugli Neto, João

doi:10.1590/S0004-282X1984000200007

Resumos

Miastenia grave é doença neuromuscular caracterizada por excessiva fatigabilidade da junção muscular e envolve, particularmente, músculos inervados por nervos cranianos. Acredita-se que o defeito esteja localizado na junção neuromuscular. Os autores estudaram os achados histoquímicos e e morfométricos em 4 pacientes com miastenia grave mostrando que as fibras do tipo II eram significativamente menores que as fibras do tipo I.

Myasthenia gravis is a neuromuscular disease characterized by excessive fatigability of muscle function and particularly involves muscles innervated by the cranial nerves. It is believed that the defect is in the neuromuscular junction. The authors studied histochemical and morphometric findings in 4 patients with myasthenia gravis showing that the type II fibres were significantly smaller than the type I fibres.

Biopsia muscular em miastenia grave: estudo histoquímico e morfométrico de 4 casos

Muscle biopsy in myasthenia gravis: histochemistry and morphometric study of 4 cases

João Norberto Stavale^I; Maria José Cavaliere^II; Sonia Maria Gagioti^II; Açucena Atalla^II; João Guidugli Neto^III

^IMédico. Serviço de Anatomia Patológica do Hospital do Servidor Público Estadual de São Paulo

^IIBióloga. Serviço de Anatomia Patológica do Hospital do Servidor Público Estadual de São Paulo

^IIIDiretor. Serviço de Anatomia Patológica do Hospital do Servidor Público Estadual de São Paulo

RESUMO

Miastenia grave é doença neuromuscular caracterizada por excessiva fatigabilidade da junção muscular e envolve, particularmente, músculos inervados por nervos cranianos. Acredita-se que o defeito esteja localizado na junção neuromuscular. Os autores estudaram os achados histoquímicos e e morfométricos em 4 pacientes com miastenia grave mostrando que as fibras do tipo II eram significativamente menores que as fibras do tipo I.

SUMMARY

Myasthenia gravis is a neuromuscular disease characterized by excessive fatigability of muscle function and particularly involves muscles innervated by the cranial nerves. It is believed that the defect is in the neuromuscular junction. The authors studied histochemical and morphometric findings in 4 patients with myasthenia gravis showing that the type II fibres were significantly smaller than the type I fibres.

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Trabalho do Serviço de Anatomia Patológica do Hospital do Servidor Público Estadual de São Paulo.

Serviço de Anatomia Patológica - Hospital do Servidor Público Estadual Francisco Morato de Oliveira, 7° andar - Rua Pedro de Toledo, 1800 - 04039, São Paulo, SP - Brasil.

1. BAJUSZ, E. - Red skeletal muscle fibers: relative independence of neural control. Science 145:938, 1964.
2. BLACK, J. T. - Neuromuscular diseases that affect the eye. Int. Ophthalmol, clin. 18:83, 1978.
3. CHAYEN, J.; BITENSKY, L. & BUTCHER, R. G. - Praticai Histochemistry. John Willey & Sons, London, 1973.
4. DUBOWITZ, V. & BROOKE, M. H. - Muscle Biopsy: a Modern Approach. W. B. Saunders, London, 1973.
5. DUBOWITZ, V. - Muscle Disorders in Childhood. W. B. Saunders, London, 1973.
6. ENGEL, A. G.; LAMBERT, E. H. & HOWARD, F. M. - Ultraestructural localization of immune complexes (IgG and C3) at the neuromuscular junction in myasthenia gravis. Neurology (Minneapolis) 27:364, 1977.
7. ENGEL, A. G.; LINDSTROM, J. M.; LAMBERT, E. H. & LENNON, V. A. - Ultrastructural localization of the acetylcholine receptor in myasthenia gravis and its experimental autoimmune model. Neurology (Minneapolis) 27:307, 1977,
8. ENGEL, Á. G. & SANTA, T. - Histometric analysis of the ultrastructure of the neuromuscular junction in myasthenia gravis and in the myasthenia syndrome. Ann. N. Y. Acad. Sci. 183:46, 1971.
9. ENGEL, W. K. - Myasthenia gravis. Ann. int. Med. 81:225, 1974.
10. ENGEL, W. K. & McFARLIN, D. E. - Muscle lesion in myasthenia gravis: discussion of a paper of Fenichel. Ann. N. T. Acad. Sci. 135:68, 1966.
11. ENGEL, W. K. & WARMOLTS, J. R. - The motor unit: disease affecting it in toto or in portio. In J. E. Desmett, ed.: New Developments in Electromyography and Clinical Neurophysiology. Karger Libri, Basel, 1973, vol. 1, pg. 141.
12. OOSTERHUIS, H.; BETHLEM, J. & FELTXAMP, T. E. W. - Muscle pathology, tymoma and immunological abnormalities in patients with myasthenia gravis. J. Neurol. Neurosurg. Psychiat. 31:460, 1968.
13. PASCUZZI, L.; SOUZA DIAS, J. C; CAVALIERE, M. J.; GAGIOTI, S. M. & MELARAGNO FILHO, R. - Miopatia ocular tipo Kiloh-Nevin. Estudo de um caso com alterações histoquimicas e ultraestruturais. Arq. Neuro-Psiquiat. (São Paulo) 37:424, 1979.
14. PATRICK, J. & LINDSTROM, J. M. - Autoimmune response to acetylcholine receptor. Science 180:871, 1973.
15. KUSSEL, D. S. - Histological changes in the striped muscles in myasthenia gravis. J. Path. Bact. 65:279, 1953.
16. SANTA, T.; ENGEL, A. G. & LAMBERT, E. H. - Histometric study of neuromuscular junction. I. Myasthenia gravis. Neurology (Minneapolis) 22:71, 1972.
17. SCHMITT, H. P. - Measurement of voluntary muscle fiber cross sections: a comparative study of different possible methods. Microsc. Acta. 77:427, 1975.
18. SIMPSON, J. A. - The correlations between myasthenia gravis: a new hypothesis. Scottish med. J. 5:419, 1960.

Datas de Publicação

Publicação nesta coleção
13 Ago 2012
Data do Fascículo
Jun 1984

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. BAJUSZ, E. - Red skeletal muscle fibers: relative independence of neural control. Science 145:938, 1964.

[2] 2. BLACK, J. T. - Neuromuscular diseases that affect the eye. Int. Ophthalmol, clin. 18:83, 1978.

[3] 3. CHAYEN, J.; BITENSKY, L. & BUTCHER, R. G. - Praticai Histochemistry. John Willey & Sons, London, 1973.

[4] 4. DUBOWITZ, V. & BROOKE, M. H. - Muscle Biopsy: a Modern Approach. W. B. Saunders, London, 1973.

[5] 5. DUBOWITZ, V. - Muscle Disorders in Childhood. W. B. Saunders, London, 1973.

[6] 6. ENGEL, A. G.; LAMBERT, E. H. & HOWARD, F. M. - Ultraestructural localization of immune complexes (IgG and C3) at the neuromuscular junction in myasthenia gravis. Neurology (Minneapolis) 27:364, 1977.

[7] 7. ENGEL, A. G.; LINDSTROM, J. M.; LAMBERT, E. H. & LENNON, V. A. - Ultrastructural localization of the acetylcholine receptor in myasthenia gravis and its experimental autoimmune model. Neurology (Minneapolis) 27:307, 1977,

[8] 8. ENGEL, Á. G. & SANTA, T. - Histometric analysis of the ultrastructure of the neuromuscular junction in myasthenia gravis and in the myasthenia syndrome. Ann. N. Y. Acad. Sci. 183:46, 1971.

[9] 9. ENGEL, W. K. - Myasthenia gravis. Ann. int. Med. 81:225, 1974.

[10] 10. ENGEL, W. K. & McFARLIN, D. E. - Muscle lesion in myasthenia gravis: discussion of a paper of Fenichel. Ann. N. T. Acad. Sci. 135:68, 1966.

[11] 11. ENGEL, W. K. & WARMOLTS, J. R. - The motor unit: disease affecting it in toto or in portio. In J. E. Desmett, ed.: New Developments in Electromyography and Clinical Neurophysiology. Karger Libri, Basel, 1973, vol. 1, pg. 141.

[12] 12. OOSTERHUIS, H.; BETHLEM, J. & FELTXAMP, T. E. W. - Muscle pathology, tymoma and immunological abnormalities in patients with myasthenia gravis. J. Neurol. Neurosurg. Psychiat. 31:460, 1968.

[13] 13. PASCUZZI, L.; SOUZA DIAS, J. C; CAVALIERE, M. J.; GAGIOTI, S. M. & MELARAGNO FILHO, R. - Miopatia ocular tipo Kiloh-Nevin. Estudo de um caso com alterações histoquimicas e ultraestruturais. Arq. Neuro-Psiquiat. (São Paulo) 37:424, 1979.

[14] 14. PATRICK, J. & LINDSTROM, J. M. - Autoimmune response to acetylcholine receptor. Science 180:871, 1973.

[15] 15. KUSSEL, D. S. - Histological changes in the striped muscles in myasthenia gravis. J. Path. Bact. 65:279, 1953.

[16] 16. SANTA, T.; ENGEL, A. G. & LAMBERT, E. H. - Histometric study of neuromuscular junction. I. Myasthenia gravis. Neurology (Minneapolis) 22:71, 1972.

[17] 17. SCHMITT, H. P. - Measurement of voluntary muscle fiber cross sections: a comparative study of different possible methods. Microsc. Acta. 77:427, 1975.

[18] 18. SIMPSON, J. A. - The correlations between myasthenia gravis: a new hypothesis. Scottish med. J. 5:419, 1960.