Chronic neuropathy associated with immune complexes of hepatitis B virus.
In 7 patients, including one autopsied case, with neuropathy associated with hepatitis B virus infection, histologic examination of sural nerve biopsies revealed small vessel vasculitis in the vasa nervorum. In all cases, immunofluorescent deposits of hepatitis B surface antigen, immunoglobulin and C3 complement were detected in the vasa nervorum. That these deposits could represent immune complexes composed of hepatitis B virus was supported by the serologic demonstration of high serum-level of immune complexes and by the ultrastructural demonstration of electron-dense deposits around the endoneural capillary and in the endoneurium. The densities of large myelinated fibers were significantly lower than controls (P less than 0.01) in 6 of 7 cases. These results suggest that immune complexes composed of hepatitis B virus might play a significant role in the pathogenesis of endoneural and epineural vascular lesions, through which neuropathy may be induced in patients with hepatitis B virus infection.
D000328:Adult; D000936:Antigen-Antibody Complex / Q000378:metabolism*; D001808:Blood Vessels / Q000276:immunology; D005260:Female; D005455:Fluorescent Antibody Technique; D006509:Hepatitis B / Q000150:complications*; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D006801:Humans; D007105:Immune Complex Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010525:Peripheral Nerves / Q000098:blood supply*; D010523:Peripheral Nervous System Diseases / Q000209:etiology*; D014657:Vasculitis / Q000209:etiology*
D000936:Antigen-Antibody Complex; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens