Estudo histoquímico do músculo esquelético na esclerose múltipla

Tilbery, Charles P.; Atra, Mauro; Oliveira, Acary S. Bulle; Calia, Leandro A.; Schmidt, Beny

doi:10.1590/S0004-282X1989000300015

Resumos

O estudo histoquímico do músculo esquelético em 10 pacientes com esclerose múltipla e atrofia muscular revelou comprometimento em todos eles. As alterações histológicas observadas mostraram padrão histológico homogêneo, não se observando diferenças entre as formas clássica e progressiva. Foram observadas: vasculite do tipo linfoplasmocitário, aumento da porcentagem de fibras do tipo UB, alterações inflamatórias ao nível dos ramos nervosos periféricos terminais, acúmulo lipídico intrassarcoplasmático e presença de fibras 'moth-eaten'. As características do infiltrado perivascular observado em nossos casos é fato que contribui para a hipótese etiopatogênica de uma lesão autoimune na esclerose múltipla.

The authors present muscle histochemistry of ten patients of multiple sclerosis. The clinical diagnosis was based on criteria established by Poser et al. (1983). The main pathological findings observed were: lymphoplasmocitary vasculitis, increase in the number of 2B type fibers, inflammatory cells (macrophages) in the intramuscular ends of the motor nerves, amounts of lipids and 'moth-eaten' fibers. The presence of vasculitis observed in our cases contributes with the etiopathogenic hypothesis of an autoimune lesion in multiple sclerosis. There is no correlation between the clinical and histological atrophy observed.

Estudo histoquímico do músculo esquelético na esclerose múltipla

Histochemistry study of the muscle in multiple sclerosis

Charles P. Tilbery^I; Mauro Atra^II; Acary S. Bulle Oliveira^III; Leandro A. Calia^IV; Beny Schmidt^V

^IDisciplina de Neurologia da Faculdade de Ciências Médicas (DNFCM) da Santa Casa de São Paulo e no Setor de Patologia Neuro-Muscular (SPNM) da Escola Paulista de Medicina (EPN): Professor Associado Doutor da DNFCM

^IIDisciplina de Neurologia da Faculdade de Ciências Médicas (DNFCM) da Santa Casa de São Paulo e no Setor de Patologia Neuro-Muscular (SPNM) da Escola Paulista de Medicina (EPN): Ex-Residente da DNFCM

^IIIDisciplina de Neurologia da Faculdade de Ciências Médicas (DNFCM) da Santa Casa de São Paulo e no Setor de Patologia Neuro-Muscular (SPNM) da Escola Paulista de Medicina (EPN): Pós-Graduando do SPNM

^IVDisciplina de Neurologia da Faculdade de Ciências Médicas (DNFCM) da Santa Casa de São Paulo e no Setor de Patologia Neuro-Muscular (SPNM) da Escola Paulista de Medicina (EPN): Sextanista da EPM

^VDisciplina de Neurologia da Faculdade de Ciências Médicas (DNFCM) da Santa Casa de São Paulo e no Setor de Patologia Neuro-Muscular (SPNM) da Escola Paulista de Medicina (EPN): Chefe do SPNM

RESUMO

O estudo histoquímico do músculo esquelético em 10 pacientes com esclerose múltipla e atrofia muscular revelou comprometimento em todos eles. As alterações histológicas observadas mostraram padrão histológico homogêneo, não se observando diferenças entre as formas clássica e progressiva. Foram observadas: vasculite do tipo linfoplasmocitário, aumento da porcentagem de fibras do tipo UB, alterações inflamatórias ao nível dos ramos nervosos periféricos terminais, acúmulo lipídico intrassarcoplasmático e presença de fibras 'moth-eaten'. As características do infiltrado perivascular observado em nossos casos é fato que contribui para a hipótese etiopatogênica de uma lesão autoimune na esclerose múltipla.

SUMMARY

The authors present muscle histochemistry of ten patients of multiple sclerosis. The clinical diagnosis was based on criteria established by Poser et al. (1983). The main pathological findings observed were: lymphoplasmocitary vasculitis, increase in the number of 2B type fibers, inflammatory cells (macrophages) in the intramuscular ends of the motor nerves, amounts of lipids and 'moth-eaten' fibers. The presence of vasculitis observed in our cases contributes with the etiopathogenic hypothesis of an autoimune lesion in multiple sclerosis. There is no correlation between the clinical and histological atrophy observed.

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1. Adams CWM - The general pathology of multiple sclerosis: morphological and chemical aspects of the lesions. In Hallpike JF, Adams CWM, Tourtellotte WW (eds): Multiple Sclerosis. Chapmann and Hall, London, 1983, pg 203.
2. Banker BQ, Engel AG - Basic reactions of muscle. In Engel AG, Banker BQ (eds): Myology. McGraw-Hill, New York, 1986, pg 845.
3. Bonduelle M, Bouygues P, Chaumont P - Amyotrophies et abolition des reflexes dans la sclerose en plaque. Sem Hop Paris 13: 814, 1964.
4. Brooke MH, Kaplan H - Muscle pathology in reumathoid arthritis, polymyalgia reu-mathica and polymiosytes. Arch Pathol 94: 101, 1972.
5. Da Cunha MFL - O músculo na artrite reumatóide: estudo anatomo-clínico-laboratorial. Tese mestrado. Escola Paulista de Medicina. São Paulo, 1987.
6. Davison C, Goodhart SP, Lander J - Multiple sclerosis and amyotrophies. Arch Neurol Psychiat 31: 270, 1984.
7. Dubowitz V, Brooke MH - Muscle biopsy: a modern approach. WB Saunders, London, 1983.
8. Fisher M, Long RR, Drachman DA - Hand muscle atrophy in multiple sclerosis. Arch Neurol 40: 811, 1983.
9. Forrester C, Lascelles G - Association between polyneuritis and multiple sclerosis. J Neurol Neurosurg Psychiat 42: 864, 1979.
10. Garcin R, Lapresle J, Fardeau M - Documents pour servir à l'étude des amyotrophies et des abolitions durables des reflexes tendineux observées dans la sclérose en plaques. Rev Neurol 107: 417, 1962.
11. Hallpike JF - Clinical aspects of multiple sclerosis. In Hallpike JF, Adams CWM, Tourtellotte WW (eds): Multiple Sclerosis. Chapmann and Hall, London, 1983, pg 129.
12. Hasson J, Terry RD, Zimmerman H - Peripheral neuropathy in multiple sclerosis. Neurology 8: 503, 1958.
13. Lassmann H, Budka H, Schnaberth G - Inflammatory demylinating polyradiculitis in a patient with multiple sclerosis. Arch Neurol 38: 99, 1981
14. Martin-Mondière C, Jacque O, Delassalle A, Cesaro P, Carydakis C, Degos JP - Cerebrospinal myelin basic protein in multiple sclerosis: identification of two groups of patients with acute exacerbation. Arch Neurol 44: 276, 1987.
15. Petajan JH - Eletromyographic findings in multiple sclerosis: remitting signs of denervation. Muscle & Nerve 5:157, 1982.
16. Poser CM, Paty D, Scheinberg D, McDonald W, Davis FA, Ebers GC, Johnson KP, Sibley WA, Silberberg DH, Tourtellotte WW - New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol 13: 227, 1983.
17. Riggs JE, Schochet SS, Kopitnik TA, Gutmann L - Target fibers in multiple sclerosis: implications for pathogenesis. Neurology 36:297, 1986.
18. Ro YI, Alexander CB, Oh SJ - Multiple sclerosis and hypertrophic demyelinating peripheral neuropathy. Muscle & Nerve 6: 312, 1983.
19. Rosenberg NL, Bourdette D - Hypertrophic neuropathy and multiple esclerosis. Neurology 33: 1361, 1983.
20. Schmidt B, Gabbai AA, Oliveira ASB, Braga MB Jr, Castelo A Filho, Laredo J Filho - A biopsia muscular: a nova metodologia 'a dança dos farabeufs'. Rev Bras Ortop 23: 21, 1988.
21. Schoene WC, Carpenter S, Behan PO, Geschwind N - Onion bulb formation in the central and peripheral nervous system in association with multiple sclerosis and hypertrophic polyneuropathy. Brain 100: 755, 1977.
22. Tachi N, Ishikawa Y, Tsuzuki A, Minami R, Sasaki K, Shinoda M - A case of childhood multiple sclerosis with peripheral neuropathy. Neuropediatrics 16: 231, 1985.
23. Weiner HL, Ellison GW - A working protocol to be used as a guideline for trials in multiple sclerosis. Arch Neurol 40: 704, 1983.

Datas de Publicação

Publicação nesta coleção
06 Jun 2011
Data do Fascículo
Set 1989

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

[1] 1. Adams CWM - The general pathology of multiple sclerosis: morphological and chemical aspects of the lesions. In Hallpike JF, Adams CWM, Tourtellotte WW (eds): Multiple Sclerosis. Chapmann and Hall, London, 1983, pg 203.

[2] 2. Banker BQ, Engel AG - Basic reactions of muscle. In Engel AG, Banker BQ (eds): Myology. McGraw-Hill, New York, 1986, pg 845.

[3] 3. Bonduelle M, Bouygues P, Chaumont P - Amyotrophies et abolition des reflexes dans la sclerose en plaque. Sem Hop Paris 13: 814, 1964.

[4] 4. Brooke MH, Kaplan H - Muscle pathology in reumathoid arthritis, polymyalgia reu-mathica and polymiosytes. Arch Pathol 94: 101, 1972.

[5] 5. Da Cunha MFL - O músculo na artrite reumatóide: estudo anatomo-clínico-laboratorial. Tese mestrado. Escola Paulista de Medicina. São Paulo, 1987.

[6] 6. Davison C, Goodhart SP, Lander J - Multiple sclerosis and amyotrophies. Arch Neurol Psychiat 31: 270, 1984.

[7] 7. Dubowitz V, Brooke MH - Muscle biopsy: a modern approach. WB Saunders, London, 1983.

[8] 8. Fisher M, Long RR, Drachman DA - Hand muscle atrophy in multiple sclerosis. Arch Neurol 40: 811, 1983.

[9] 9. Forrester C, Lascelles G - Association between polyneuritis and multiple sclerosis. J Neurol Neurosurg Psychiat 42: 864, 1979.

[10] 10. Garcin R, Lapresle J, Fardeau M - Documents pour servir à l'étude des amyotrophies et des abolitions durables des reflexes tendineux observées dans la sclérose en plaques. Rev Neurol 107: 417, 1962.

[11] 11. Hallpike JF - Clinical aspects of multiple sclerosis. In Hallpike JF, Adams CWM, Tourtellotte WW (eds): Multiple Sclerosis. Chapmann and Hall, London, 1983, pg 129.

[12] 12. Hasson J, Terry RD, Zimmerman H - Peripheral neuropathy in multiple sclerosis. Neurology 8: 503, 1958.

[13] 13. Lassmann H, Budka H, Schnaberth G - Inflammatory demylinating polyradiculitis in a patient with multiple sclerosis. Arch Neurol 38: 99, 1981

[14] 14. Martin-Mondière C, Jacque O, Delassalle A, Cesaro P, Carydakis C, Degos JP - Cerebrospinal myelin basic protein in multiple sclerosis: identification of two groups of patients with acute exacerbation. Arch Neurol 44: 276, 1987.

[15] 15. Petajan JH - Eletromyographic findings in multiple sclerosis: remitting signs of denervation. Muscle & Nerve 5:157, 1982.

[16] 16. Poser CM, Paty D, Scheinberg D, McDonald W, Davis FA, Ebers GC, Johnson KP, Sibley WA, Silberberg DH, Tourtellotte WW - New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol 13: 227, 1983.

[17] 17. Riggs JE, Schochet SS, Kopitnik TA, Gutmann L - Target fibers in multiple sclerosis: implications for pathogenesis. Neurology 36:297, 1986.

[18] 18. Ro YI, Alexander CB, Oh SJ - Multiple sclerosis and hypertrophic demyelinating peripheral neuropathy. Muscle & Nerve 6: 312, 1983.

[19] 19. Rosenberg NL, Bourdette D - Hypertrophic neuropathy and multiple esclerosis. Neurology 33: 1361, 1983.

[20] 20. Schmidt B, Gabbai AA, Oliveira ASB, Braga MB Jr, Castelo A Filho, Laredo J Filho - A biopsia muscular: a nova metodologia 'a dança dos farabeufs'. Rev Bras Ortop 23: 21, 1988.

[21] 21. Schoene WC, Carpenter S, Behan PO, Geschwind N - Onion bulb formation in the central and peripheral nervous system in association with multiple sclerosis and hypertrophic polyneuropathy. Brain 100: 755, 1977.

[22] 22. Tachi N, Ishikawa Y, Tsuzuki A, Minami R, Sasaki K, Shinoda M - A case of childhood multiple sclerosis with peripheral neuropathy. Neuropediatrics 16: 231, 1985.

[23] 23. Weiner HL, Ellison GW - A working protocol to be used as a guideline for trials in multiple sclerosis. Arch Neurol 40: 704, 1983.