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Diabetic Neuropathy
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Diabetic amyotrophy may be caused by an immune system abnormality that damages small blood vessels supplying the leg nerves – microvasculitis. Development of diabetic amyotrophy is not likely related to the duration of diabetes or its severity. However, amyotrophy only rarely occurs without diabetes. Increased blood glucose may not directly cause nerve damage, but somehow contributes to the damage process.
Cellular and Extracellular Abnormalities
Published in Maher Kurdi, Neuromuscular Pathology Made Easy, 2021
When an active inflammatory infiltrate is detected, the cell types should be identified. Perivascular cuffing with mononuclear cells is a common observation and is more readily recognized with CD45 immunostaining. They can be seen in normal nerves or in non-inflammatory neuropathies. Pathologists should be careful in interpreting these cells as they may be confused with microvasculitis. Therefore, it is better to call this kind of inflammatory infiltrate perivascular cuffing. CD4, CD8 and CD20 markers should also be done to rule out inflammation. The presence of neutrophils inside the blood vessel lumen is considered insignificant whereas the presence of lymphocytes within the lumen is very significant, as it raises the suspicion of vasculitic diseases.
Diseases of the Peripheral Nerve and Mononeuropathies
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Diana Mnatsakanova, Charles K. Abrams
Other monikers include diabetic amyotrophy, Bruns–Garland syndrome, or proximal diabetic neuropathy. It predominantly affects individuals with type 2 diabetes. The pathogenesis is believed to be a T-cell–mediated microvasculitis involving small epineurial and perineurial vessels.8
Donor-specific antibodies following liver and intestinal transplantation: Clinical significance, pathogenesis and recommendations
Published in International Reviews of Immunology, 2019
Laura J. Wozniak, Robert S. Venick
The guidelines and consensus criteria for liver AMR recently introduced by the Banff Working Group include (a) histopathological pattern of injury consistent with acute AMR; (b) positive serum DSA; (c) diffuse microvascular C4d deposition; (d) reasonable exclusion of other insults (Table 2) [11]. The list of histopathological features consistent with AMR includes portal microvascular endothelial cell hypertrophy, portal capillary and inlet venule dilatation, monocytic, eosinophilic, and neutrophilic portal microvasculitis, portal edema, ductular reaction, cholestasis, edema and periportal hepatocyte necrosis, and active lymphocytic and/or necrotizing arteritis [11]. While it should be noted that C4d staining in liver biopsies is not unique for AMR [62], diffuse microvascular C4d deposition is part of the Banff criteria [11].
Contralateral lumbosacral plexopathy following lumbar microdiscectomy
Published in British Journal of Neurosurgery, 2020
Isabel Tulloch, Riaz Ali, Marios C. Papadopoulos
As has been observed with diabetic and idiopathic LSP, neurosarcoid has also been associated with perineuritis and vasculitic changes.17 Given our patient’s background of sarcoidosis, there is the possibility that pre-operatively she may have had clinically occult involvement of her right lumbosacral plexus. This involvement was then brought to the forefront by the physiological stress of recent surgery with resultant microvasculitis and subsequent ischaemia causing her plexopathy.