Paraneoplastic vasculitic neuropathy: immunohistochemical studies on a biopsied nerve and post-mortem examination.
We studied a patient with paraneoplastic vasculitic neuropathy (PVN) associated with a carcinoma of the common bile duct. Immunohistochemical analysis of the biopsied sural nerve showed that the cellular infiltrates in the vascular lesions were composed primarily of CD8-positive T lymphocytes and macrophages. Pathogenic significance of the T-cell-mediated immunological reaction was suggested. Post-mortem examination revealed the absence of systemic vasculitis, which may be a characteristic feature of PVN. The patient responded to immunosuppressive treatment. We discuss the efficacy and the risk of immunosuppressive therapy for PVN.
Matsumuro
K
K
Third Department of Internal Medicine, Kagoshima University School of Medicine, Japan.
Izumo
S
S
Umehara
F
F
Arisato
T
T
Maruyama
I
I
Yonezawa
S
S
Shirahama
H
H
Sato
E
E
Osame
M
M
D000230:Adenocarcinoma / Q000150:complications / Q000473:pathology*; D003138:Common Bile Duct Neoplasms / Q000150:complications / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010257:Paraneoplastic Syndromes / Q000209:etiology / Q000473:pathology*; D010523:Peripheral Nervous System Diseases / Q000209:etiology / Q000473:pathology*; D013497:Sural Nerve / Q000473:pathology; D014657:Vasculitis / Q000209:etiology / Q000473:pathology*