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Hypertrophic neuritis due to chronic inflammatory demyelinating polyradiculoneuropathy (CIDP): a postmortem
M Matsuda1, S Ikeda, S Sakurai
1Department of Medicine (Neurology), Shinshu University School of Medicine, Matsumoto, Japan.
Muscle & Nerve
|February 1, 1996
Summary
This study details a case of hypertrophic neuritis, a form of chronic inflammatory demyelinating neuropathy (CIDP), revealing nerve swelling and fiber loss. Findings suggest CIDP affects both somatic and visceral nerves, showing diverse pathology.
Area of Science:
- Neuropathology
- Clinical Neurology
Background:
- Hypertrophic neuritis is a rare condition characterized by nerve enlargement.
- Chronic inflammatory demyelinating polyneuropathy (CIDP) can present with diverse clinical and pathological features.
Observation:
- A postmortem pathological examination of a 65-year-old woman with hypertrophic neuritis, hand tremor, and limb ataxia was performed.
- Significant findings included numerous "onion bulbs" and loss of myelinated nerve fibers in peripheral nerves, including facial and visceral nerves.
Findings:
- The observed hypertrophic neuritis was attributed to chronic inflammatory demyelinating neuropathy (CIDP).
- Interstitial amorphous substances and onion bulb formation in the endoneurium likely contributed to nerve swelling.
- Pathological changes in CIDP appear more heterogeneous than previously understood, involving both somatic and visceral autonomic nerves.
Implications:
- This case highlights the potential involvement of visceral autonomic nerves in long-standing CIDP.
- The findings suggest a broader spectrum of peripheral nerve pathology in CIDP, necessitating comprehensive diagnostic approaches.