Inflammatory vasculopathy in multifocal XXXX .

@entity1 @entity17 @entity66 @entity6 @entity1333 @entity3120 @entity548 @entity16 @entity245 @entity305 @entity3949 @entity1514 @entity51 @entity158 @entity5433 @entity528 @entity68
Besides the common distal symmetrical sensory-motor @entity305 (DSP) that is often associated with @entity5433 , @entity6 @entity1 @entity245 ( @entity245 ) secondary to roots, plexus and nerve trunk involvement. Nerve ischaemia has been suggested as a common mechanism for the different patterns of @entity3949 , yet the important clinical differences that exist between DSP and @entity245 suggest concurrent factors. In order to learn more on the subject, we prospectively studied 22 consecutive @entity6 @entity1 with @entity245 , for which other causes of @entity16 were excluded by appropriate investigations, including biopsy of a recently affected sensory nerve. Three @entity1 had a relapsing course, and the others an unremitting subacute-progressive course. @entity158 @entity245 progressed over 2-12 months. The @entity51 predominated in distal lower limbs which were involved in all @entity1 , unilaterally in seven, bilaterally in the others, with an asynchronous onset in most cases. In addition, a proximal deficit of the lower limbs was present on one side in seven @entity1 , and on both sides in six. @entity1514 was present bilaterally in two @entity1 , and unilaterally in one. The ulnar nerve was involved in one @entity1 , and the radial nerve in two. The CSF protein ranged from 0.40 to 3.55 g/l; mean: 0.87 g/l. Electrophysiological testing showed severe, multifocal, @entity66 in all cases. Asymmetrical axonal lesions were found in all nerve specimens. The mean density of myelinated axons was reduced to 1340 +/- 1070 per mm(2) of endoneurial area versus 8370 +/- 706 myelinated fibres/mm(2) in controls. The mean density of unmyelinated fibres was reduced to 5095 +/- 6875 per mm(2) (extremes: 0-26 600). On teased fibre preparations, 34 +/- 31% of the fibres were at different stages of @entity528 (extremes 0-99%); 7 +/- 6% of the fibres @entity17 . @entity1333 of @entity3120 were found in six @entity1 . Endoneurial seepage of red cells was present in 11 specimens, and endoneurial @entity548 in five. Ferric @entity68 deposits that characterize previous @entity548 were found in seven @entity1 , including two who had no red cells in the endoneurium. Perivascular mononuclear cell infiltrates were present in the nerve specimens of 21 out of 22 @entity1 , prominently in four @entity1 . In comparison, nerve biopsy specimens of 30 @entity1 with severe distal symmetrical @entity3949 showed mild epineurial mononuclear cell infiltrate in one @entity1 and endoneurial seepage of red cells in another. We conclude that @entity245 is related to pre-capillary blood vessel involvement in elderly @entity6 @entity1 with a secondary inflammatory response.
