Necrose medular maciça após vacinação antirrábica

Carvalhal, José Paulo

doi:10.1590/S0004-282X1968000100008

Resumos

Descrição de um caso de necrose maciça da medula espinhal por vacinação antirrábica. A doença caracterizou-se por paralisia de tipo ascendente e hipertermia. As investigações histológicas revelaram, na medula espinhal, extensas áreas de necrose, hemorragias, zonas de desmielinização, infiltrados linfocitários, além de infiltrados linfocitários no bulbo e nas meninges. A neuralergia explicaria o mecanismo patogênico e a distribuição da rede arterial condicionaria a topografia das lesões.

Acase of acute necrosis of the spinal cord after antirabic vaccination s reported. The clinical course was characterized by Landry's ascending jaralysis and hyperthermia. The histopathological examination showed exensive necrotic areas, demyelinated zone, haemorragic and lymphocytic nfiltrates in the spinal cord; in the medulla and meninges there were ymphocytic infitrates. Neuroallergy would explain the pathogenic mechalism and the arterial distribution the lesion's topography.

Necrose medular maciça após vacinação antirrábica

Massive necrosis of the spinal cord after anti-rabic vaccination

José Paulo Carvalhal

Professor adjunto de Anatomia (Regente de Neuranatomia) na Faculdade de Medicina da Universidade Federal do Rio de Janeiro; Consultor de Neurologia do Isolamento Francisco de Castro (Rio de Janeiro, GB)

RESUMO

Descrição de um caso de necrose maciça da medula espinhal por vacinação antirrábica. A doença caracterizou-se por paralisia de tipo ascendente e hipertermia. As investigações histológicas revelaram, na medula espinhal, extensas áreas de necrose, hemorragias, zonas de desmielinização, infiltrados linfocitários, além de infiltrados linfocitários no bulbo e nas meninges. A neuralergia explicaria o mecanismo patogênico e a distribuição da rede arterial condicionaria a topografia das lesões.

SUMMARY

Acase of acute necrosis of the spinal cord after antirabic vaccination s reported. The clinical course was characterized by Landry's ascending jaralysis and hyperthermia. The histopathological examination showed exensive necrotic areas, demyelinated zone, haemorragic and lymphocytic nfiltrates in the spinal cord; in the medulla and meninges there were ymphocytic infitrates. Neuroallergy would explain the pathogenic mechalism and the arterial distribution the lesion's topography.

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Rua Sambaiba 63. Leblon Rio de Janeiro, GB Brasil.

Nota do autor Agradeço a colaboração dos médicos do Hospital Central da Marinha, ressaltando o auxílio dos Drs. Carlos Murta e Silva Araújo.

1. ALVORD Jr., E. C. Pathogenesis of experimental allergic encephalomyelitis. Annals New York Acad. Sciences 122:245, 1965.
2. ASSIS, J. L. & DUCHÉNNE, G. H. Complicaçőes neurológicas da vacinaçăo anti-rábica. Arq. Neuro-Psiquiat. (Săo Paulo) 17:235, 1959.
3. BLATT, N. H. & LEPPER, M. H. Reactions following antirrabies vaccination. Am. J. Dis. Child 86:395, 1953.
4. COELHO, R. S.; ALVES, A. & MOREIRA, A. Tratamento antirrábico (de 1950-1956) no Instituto Pasteur do Rio de Janeiro. Brasil Médico 72:129, 1958.
5. CORBIN, J. L. Anatomie et Pathologie Arterielles de la Moelle. Masson & Cie., Paris, 1961.
6. DE VRIES, E. Postvaccinia! Perivenous Encephalitis. Elsevier Publishing Co., Amsterdam, 1960.
7. FERRARO, A. Research project on ethiopathogenesis and treatment of demyelinating diseases. World Neurology 2:343, 1961.
8. FERRARO, A.; ROIZIN, L. & CAZZULO, C. L. Experimental studies in allergic encephalomyelitis: prevention and production. J. Neuropath. Exper. Neurol. 9:18, 1950.
9. FRICK, E. & LAMP, 1' Experimentei le Untersuchungen ueber eine allergische Tuberculin-Reaktion des Zentralnervensystems. Z. Hyg. 137:130, 1953.
10. GOLDSTEIN, N. P.; KIES, M. W.; KARSON, A. C; KOLB, L. C; MASSON, H. L. & SAYRE, G. P. Experimental allergic encephalomyelitis following administration of homologous brain lipid fractions. Neurology 5:550, 1955.
11. GROSSIORD, A.; LAPRESLE, J. & HELD, J. P. Tetraparesie par ramollisement cervical inferieur dans le territoire de la spinale anterieure. R. Neurol. 100:430. 1959.
12. HEITMANN, R. & MANNWEILER, K. Untersuchungen ueber allergische Polyneuritis. Dtsch. Z. Nervenheilk. 177:28, 1958.
13. JERVIS, G. A. Experimental allergic encephalitis in animals. Bull. World Health Org. 10:837, 1954.
14. KALM, H. Zur Bedeutung des Hirnkreislaufes fuer die Entwicklung und Lokalisation der entzuendlichen Erkrankungen des Zentralnervensystems. 5.° Congresso Int. Neurologia, Lisboa, 1954.
15. KERSTING, G. & PETTE, E. Zur Pathologie und Pathogenese der expe-rimentellen allergischen Encephalomyelitis des Affen. Dtsch. Z. Nervenheik. 176:387, 1957.
16. LAZORTHES, G. Vascularisation et Circulation Cerebrales. Masson & Cie., Paris, 1961.
17. MORRISON, L. R. Disseminated encephalomyelitis experimentally produced by use of homologous antigen. Arch. Neurol. & Psychiat. 58:391, 1947.
18. PELLET, H. Encephalomyelites et polyradiculoneurites allergiques experimentales. Prčsse Méd. 74:661, 1966.
19. PETTE, H. Postvacinale Encephalitis. InHdb. d. Neurologie, Bumke & Foerster, B. 13, 2. Teil. Julius Springer, Berlin, 1936.
20. PETTE, H. & KALM, H. Die entzuendlichen Erkrankungen des Gehirns und seiner Haute. InHdb. d. Inn. Med., Mohr & Staehlin, 4. Auflage, Teil 3. J. Springer, Berlin-Goettingen-Heidelberg, 1953.
21. PETTE, H. & PETTE, E. Zur Ethiopathogenese der Entmarkungs-Encephalomyelitis. Klin. Wschr. 34:713, 1956.
22. SEITELBERGER, F. & JELLINGER, K. Die pathologische Anatomie der allergischen Erkrankungen des Nervensystems. Wien. Klin. Wschr. 75:475, 1963.
23. UCHIMURA, Y. & SHIRAKI, H. A contribution to the classification and the pathogenesis of demyelinating encephalomyelitis. J. Neuropath, exp. Neurol. 16:139, 1957.
24. WAKSMAN, B. H. Further study of skin reactions in rabbits with experimental allergic encephalomyelitis. Reactions to tests with purified white matter fractions. Use of a quantitative technique for evaluating production of sensitization and disease by intradermal injection of antigen without adjuvant. J. Infect. Dis. 99:258, 1956.
25. ZUELCH, K. J. Mangeldurchblutung and den Grenzen zweier Gefaessgebiete ais Ursache bisher ungeklaerter Rueckenmarksschaedigungen. Dtsch. Z. Nervenheilk. 172:81, 1954.

Datas de Publicação

Publicação nesta coleção
14 Maio 2013
Data do Fascículo
Mar 1968

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

[1] 1. ALVORD Jr., E. C. Pathogenesis of experimental allergic encephalomyelitis. Annals New York Acad. Sciences 122:245, 1965.

[2] 2. ASSIS, J. L. & DUCHÉNNE, G. H. Complicaçőes neurológicas da vacinaçăo anti-rábica. Arq. Neuro-Psiquiat. (Săo Paulo) 17:235, 1959.

[3] 3. BLATT, N. H. & LEPPER, M. H. Reactions following antirrabies vaccination. Am. J. Dis. Child 86:395, 1953.

[4] 4. COELHO, R. S.; ALVES, A. & MOREIRA, A. Tratamento antirrábico (de 1950-1956) no Instituto Pasteur do Rio de Janeiro. Brasil Médico 72:129, 1958.

[5] 5. CORBIN, J. L. Anatomie et Pathologie Arterielles de la Moelle. Masson & Cie., Paris, 1961.

[6] 6. DE VRIES, E. Postvaccinia! Perivenous Encephalitis. Elsevier Publishing Co., Amsterdam, 1960.

[7] 7. FERRARO, A. Research project on ethiopathogenesis and treatment of demyelinating diseases. World Neurology 2:343, 1961.

[8] 8. FERRARO, A.; ROIZIN, L. & CAZZULO, C. L. Experimental studies in allergic encephalomyelitis: prevention and production. J. Neuropath. Exper. Neurol. 9:18, 1950.

[9] 9. FRICK, E. & LAMP, 1' Experimentei le Untersuchungen ueber eine allergische Tuberculin-Reaktion des Zentralnervensystems. Z. Hyg. 137:130, 1953.

[10] 10. GOLDSTEIN, N. P.; KIES, M. W.; KARSON, A. C; KOLB, L. C; MASSON, H. L. & SAYRE, G. P. Experimental allergic encephalomyelitis following administration of homologous brain lipid fractions. Neurology 5:550, 1955.

[11] 11. GROSSIORD, A.; LAPRESLE, J. & HELD, J. P. Tetraparesie par ramollisement cervical inferieur dans le territoire de la spinale anterieure. R. Neurol. 100:430. 1959.

[12] 12. HEITMANN, R. & MANNWEILER, K. Untersuchungen ueber allergische Polyneuritis. Dtsch. Z. Nervenheilk. 177:28, 1958.

[13] 13. JERVIS, G. A. Experimental allergic encephalitis in animals. Bull. World Health Org. 10:837, 1954.

[14] 14. KALM, H. Zur Bedeutung des Hirnkreislaufes fuer die Entwicklung und Lokalisation der entzuendlichen Erkrankungen des Zentralnervensystems. 5.° Congresso Int. Neurologia, Lisboa, 1954.

[15] 15. KERSTING, G. & PETTE, E. Zur Pathologie und Pathogenese der expe-rimentellen allergischen Encephalomyelitis des Affen. Dtsch. Z. Nervenheik. 176:387, 1957.

[16] 16. LAZORTHES, G. Vascularisation et Circulation Cerebrales. Masson & Cie., Paris, 1961.

[17] 17. MORRISON, L. R. Disseminated encephalomyelitis experimentally produced by use of homologous antigen. Arch. Neurol. & Psychiat. 58:391, 1947.

[18] 18. PELLET, H. Encephalomyelites et polyradiculoneurites allergiques experimentales. Prčsse Méd. 74:661, 1966.

[19] 19. PETTE, H. Postvacinale Encephalitis. InHdb. d. Neurologie, Bumke & Foerster, B. 13, 2. Teil. Julius Springer, Berlin, 1936.

[20] 20. PETTE, H. & KALM, H. Die entzuendlichen Erkrankungen des Gehirns und seiner Haute. InHdb. d. Inn. Med., Mohr & Staehlin, 4. Auflage, Teil 3. J. Springer, Berlin-Goettingen-Heidelberg, 1953.

[21] 21. PETTE, H. & PETTE, E. Zur Ethiopathogenese der Entmarkungs-Encephalomyelitis. Klin. Wschr. 34:713, 1956.

[22] 22. SEITELBERGER, F. & JELLINGER, K. Die pathologische Anatomie der allergischen Erkrankungen des Nervensystems. Wien. Klin. Wschr. 75:475, 1963.

[23] 23. UCHIMURA, Y. & SHIRAKI, H. A contribution to the classification and the pathogenesis of demyelinating encephalomyelitis. J. Neuropath, exp. Neurol. 16:139, 1957.

[24] 24. WAKSMAN, B. H. Further study of skin reactions in rabbits with experimental allergic encephalomyelitis. Reactions to tests with purified white matter fractions. Use of a quantitative technique for evaluating production of sensitization and disease by intradermal injection of antigen without adjuvant. J. Infect. Dis. 99:258, 1956.

[25] 25. ZUELCH, K. J. Mangeldurchblutung and den Grenzen zweier Gefaessgebiete ais Ursache bisher ungeklaerter Rueckenmarksschaedigungen. Dtsch. Z. Nervenheilk. 172:81, 1954.