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PubMed1995

Vascular changes in major and lingual minor salivary glands in primary Sjögren's syndrome.

A histological investigation of the vascular changes of three major and lingual minor salivary glands in primary Sjögren's syndrome was carried out on eight autopsied Japanese patients. This study compares vascular lesions in salivary glands between one group of four short-term corticosteroid-treated patients (Cases 1, 3, 4 and 7) and the other group of four long-term corticosteroid-treated patients (Cases 2, 5, 6 and 8). We proposed the following five stages for morphogenesis of arteritis; (1) endothelial swelling, (2) thrombosis, (3) fibrinoid degeneration, (4) necrotizing panarteritis and (5) endarteritis obliterans. Endothelial swelling was seen in small-to-large arteries of major salivary glands and the tongue, and this finding was considered as the initial change of vascular lesion. Thrombosis was observed in the small arteries of both organs. Fibrinoid degeneration and necrotizing panarteritis were predominantly localized in small and middle-sized arteries. Endarteritis obliterans was observed in small and large arteries of major and lingual minor salivary glands in primary Sjögren's syndrome. Vascular lesion of this type was common in the four patients who received corticosteroid for more than 12 months. Corticosteroid therapy appears to accelerate the fibrotic change of the vascular wall. Therefore, we suggest that essential vascular lesions of major and lingual minor salivary glands in primary Sjögren's syndrome may include four types (endothelial swelling, thrombosis, fibrinoid degeneration and necrotizing panarteritis), excluding endarteritis obliterans.

Adrenal Cortex Hormones↗
PubMed1999

Infectious complications related to the use of the angio-seal hemostatic puncture closure device.

One hundred and eight coronary angiography procedures in which the Angio-Seal device was utilized were complicated by eight (7.4%) hematomas, of which two (1.9%) subsequently developed infection (Staphylococcus aureus endarteritis and S. aureus septic hematoma). The Angio-Seal device may be a risk factor for infection for two reasons: excessive hematoma formation (a known risk factor for endarteritis), and foreign material remaining within the arterial lumen and wall, thereby creating a nidus for infection.

Adult↗
PubMed1987

Vasculitis in primary Sjögren's syndrome. Histologic classification and clinical presentation.

Nine out of 70 patients with primary Sjögren's syndrome had vasculitis of small and/or medium-sized vessels. The small vessel vasculitis was of the hypersensitivity type: leukocytoclastic and lymphocytic. The medium vessel vasculitis was acute necrotizing and simulated polyarteritis nodosa histologically but lacked the characteristic aneurysmal formation. A healing stage of vasculitis, presenting as endarteritis obliterans, was seen in patients with Sjögren's syndrome and a long-standing history of vasculitis. The hypersensitivity vasculitis was localized mainly in the skin and provided mild clinical symptoms. The polyarteritis nodosa-like vasculitis was localized predominantly in internal organs and was associated with life-threatening symptoms. Endarteritis obliterans was mainly seen in acral sites of the extremities and presented with recurrent symptoms of obstruction. One patient died of vasculitis. The remaining patients are alive. The presence of anemia, cryoglobulinemia, and hypocomplementemia suggested an immune-complex origin of the vasculitic process.

Adult↗
PubMed1991

Platelet aggregating activity in serum from patients with HLA-B27 associated rheumatic and cardiac disorders: a possible link to the proliferative vascular changes.

OBJECTIVE: To search for possible serum factors (immunochemical abnormalities) that reflect HLA-B27 associated inflammatory process with the proliferative endarteritis, which is an important cause of severe bradycardia and aortic valve regurgitation. PATIENTS AND METHODS: Seventy four men with pacemakers were studied: 24 were HLA-B27 positive and had associated rheumatic and cardiac disorders, 13 were B27 positive but had no clinical or radiographic signs of a related rheumatic condition, and 37 were B27 negative controls. Randomly obtained serum samples were examined for a series of serum factors. RESULTS: Thirteen (57%) of the 23 patients with HLA-B27 and associated rheumatic and cardiac conditions had platelet aggregating activity in their serum. No such activity was found in sera from patients in the other groups. None the less, immunochemical abnormalities were common among patients of all groups; 30 (41%) had antinuclear antibodies or rheumatoid factor or both. CONCLUSION: The platelet aggregating activity found in patients with HLA-B27 and associated rheumatic and cardiac conditions may reflect serum factors that increase the stickiness of platelets and increase their adhesion to the vessel wall. This suggests a link via release of platelet derived growth factor(s) with the characteristic histopathological feature of proliferative endarteritis. Immunochemical abnormalities were common in serum from all men with pacemakers.

Adult↗
PubMed1977

An epizootic among knots (Calidris canutus) in Florida. I. Disease syndrome, histology and transmission studies.

About 150 knots found sick or dead had distention of serosal blood vessels, and small, raised hemorrhagic foci on the serosal surface of the jejunum and ileum. The principal finding was endaortitis with large intimal multinucleated cysts that contained a protozoan parasite within a cytoplasmic vacuole. There was endarteritis of mesenteric arteries and muscular arteries of the external layers of the intestinal tract. Single or multiple schizont-like stages containing zoites were in the wall of the small intestine and close to affected muscular arteries. The more usual intestinal lesion was an aneurysm of the inflamed muscular artery. It was concluded that endarteritis led to colonic infarction. Schizonts in medullary renal tubular cells were smaller than stages in the intestine. There was necrosis of epithelial cells of themedullary collecting ducts and inflammatory and regenerative changes. Schizonts and zoites were free in collecting ducts and ureters.

Animals↗
PubMed1989

[Differential diagnosis of ischemic syndrome of the lower extremities at an angiology department of a polyclinic].

A total of 1545 patients, referred with the diagnosis of obliterating endarteritis to the angiologic unit of the Irkutsk Vascular Centre from various other medical institutions, are examined. Differential diagnosis of the ischemic lower limb syndrome, rooted in vascular and other diseases, is shown to be possible, using noninvasive diagnostic procedures on an outpatient basis. The diagnosis of obliterating endarteritis was only verified in 18.2% of the patients. Atherosclerosis was detected in 41.2% of the patients, aortoarteritis, in 4.7%, diabetic angiopathy, in 5.6%, and nonvascular pathology, in 30.3%. A schedule is proposed for differential diagnosis of the lower limb ischemic syndrome.

Adult↗
PubMed1983

Vascular ulcers in scleroderma.

Seven patients with scleroderma and either livedo reticularis or atrophie blanche lesions had ulcers of the lower extremity. Livedoid vasculitis, periarteritis nodosa, or endarteritis obliterans lesions were associated with the ulcers. Five patients had livedoid vasculitis, one patient had associated lupus panniculitis, and one patient had rheumatoid arthritis. Four patients had elevated ESRs, four had positive antinuclear antibody tests, and two had positive tests for rheumatoid factor. Patients with scleroderma and livedoid vasculitis or livedo reticularis and ulcers should be examined to rule out underlying vascular disease or endarteritis obliterans.

Adolescent↗
PubMed1994

Morphologic features of chronic rejection in kidney and less commonly transplanted organs.

Chronic rejection is characterized by morphological evidence of destruction of the transplanted organ. The injury to the organ is associated with collagenization of variable degree. The destruction and fibrosis of the organ is probably the result of 1) direct alloimmune cytotoxic injury (i.e., acute and/or ongoing rejection) of the organ tissue, and 2) end-organ ischemic injury secondary to fibroproliferative endarteritis (i.e., chronic vascular rejection). The cardinal morphological feature of chronic rejection in all allografts is fibroproliferative endarteritis, which is characterized by widening of the subendothelial space due to a cellular fibrosis which may have an onion-skin appearance with a PAS or silver stain. Macrophages with foamy cytoplasm and lymphocytes may be present in this fibrotic tissue. The smooth muscle wall may show foci of fibrosis as well, if involved by previous necrotizing rejection. These features are commonly found in needle core biopsies of kidney allografts and may involve the interlobular, arcuate, and interlobar arteries. They are less commonly found in pancreatic needle biopsies, and only rarely in hepatic and pulmonary allograft biopsies, rendering the diagnosis of chronic rejection often difficult to establish. Though the vascular lesions may not be apparent in biopsies, they are typically found in explanted organs where larger vessels can be examined. Thus, the diagnosis of chronic rejection may rest upon other and in some instances less specific abnormalities, usually ischemic in origin due to vascular lesions and consequent decreased perfusion of the graft.(ABSTRACT TRUNCATED AT 250 WORDS)

Bronchiolitis Obliterans↗
PubMed1993

[Effectiveness of pathogenetic treatment of arterial obliterative diseases of the extremities].

The authors studied the activity of blood serum amine oxidase in patients with atherosclerosis obliterans and endarteritis obliterans. It was found that amine oxidase activity exceeded the normal value. 2.6 times in patients with stage 1-2 atherosclerosis obliterans and was reduced by more than 12 times in patients with stage 3-4 of the disease. The activity of the enzyme was absent in patients with endarteritis obliterans, whatever the stage of limb ischemia. On the basis of the obtained facts, the authors voice a new opinion on the nature of hypercatecholaminemia in obliterative diseases and suggest a new trend in the treatment of chronic ischemia of the limbs-activation of the processes of catabolism of vasoconstrictive biogenic amines.

Adult↗
PubMed1992

Mechanism of action of injection therapy for bleeding peptic ulcer.

The effects of intramucosal injection of 1:100,000 adrenaline, 5 per cent ethanolamine and normal saline were determined in experimentally created, acutely bleeding gastric mucosal wounds in rabbits. The mean(s.d.) bleeding rate was decreased from 2.3(0.4) to 0.2(0.02) ml/min by adrenaline (P < 0.01), but increased by 1 ml 5 per cent ethanolamine to 4.0(0.6) ml/min (P < 0.05). Normal saline had no haemostatic effect, suggesting that local tamponade is not important. In separate experiments endoscopic injections of 5 per cent ethanolamine, 1:100,000 adrenaline and normal saline were made in the gastric antrum of rabbits. After 48 h the degree of inflammation was greatest with ethanolamine but, despite tissue necrosis and venous thrombosis, neither endarteritis nor arterial thrombosis occurred. Injections of 5 per cent ethanolamine and 80 per cent ethanol placed next to the ear arteries of rabbits caused local ulceration and necrosis, but endarteritis and arterial thrombosis were again absent.

Animals↗
PubMed1992

Mycotic aneurysm of the descending aorta diagnosed by echocardiography.

We present a 3-yr-old girl with coarctation of aorta and patent ductus arteriosus in whom mycotic aneurysm and bacterial endarteritis developed postoperatively and was diagnosed by two-dimensional and Doppler echocardiography. Five weeks after the operation of ligation of ductus and resection of coarctated segment, the patient was readmitted with complaints of vomiting, fever and coughing. Bacterial endarteritis, empyema and septic arthritis were diagnosed. Suprasternal echocardiographic examination demonstrated an aneurysmatic appearance 60 x 65 mm in size at the location of coarctation. The patient died, most probably due to aortic rupture, before surgical treatment could be undertaken. Autopsy study confirmed our diagnosis.

Aneurysm, False↗
PubMed1996

Infectious endocarditis due to non-typhi Salmonella in patients infected with human immunodeficiency virus: report of two cases and review.

Endocarditis is not usually considered a complication of AIDS. Because salmonellal bacteremia is common in HIV-infected patients and because salmonellae have a propensity to adhere to endothelial cells, these patients are at risk of endocarditis and endarteritis. We report two cases of endocarditis due to Salmonella enteritidis and review three previously reported cases. All five patients had underlying heart valve disease and developed fever, breakthrough or relapsing bacteremia, heart murmurs, and cardiac failure; four of five patients were older than 45 years. One patient died, but the other four were successfully treated with beta-lactam agents alone or in combination with aminoglycosides or with ofloxacin (valve replacement was not required). As AIDS patients get older, the number of cases of endocarditis or endarteritis due to Salmonella species may increase, particularly in geographic areas where Salmonella species are prevalent.

AIDS-Related Opportunistic Infections↗
PubMed2004

The histopathology of syphilis of the oral mucosa.

BACKGROUND: Reported cases of syphilis in the United States, Europe and elsewhere are increasing in number. Clinical manifestations are protean, and oral biopsies may be taken where the diagnosis is unsuspected, but data on the histopathology of oral mucosal syphilis are sparse. METHODS: The histopathology of five oral lesions in patients with serologically proven syphilis was reviewed. RESULTS: There were two cases of primary syphilis, one secondary and two tertiary. Epithelial hyperplasia was present in three cases, and was pseudocarcinomatous in one case of primary syphilis, and psoriasiform in the secondary lesion, where heaped-up epithelium surrounded a defined crater covered by flatter epithelium. Plasma cell (primary and secondary disease) and granulomatous (tertiary) infiltrates were prominent. Other features observed were endarteritis (5/5), plasma cell neuritis (3/5) and spirochetes (4/5). CONCLUSIONS: Although no single microscopic feature is specific, a diagnosis of syphilis should be considered where there is unusual epithelial hyperplasia, granulomatous or plasma cell-predominant chronic inflammation, endarteritis and neuritis.

Adult↗
PubMed1993

Mycotic aneurysm of left subclavian artery.

Bacterial endarteritis is rare and usually affects the abdominal aorta. A case of bacterial left subclavian arteritis complicated by mycotic aneurysm is presented. An early diagnosis of infective arteritis was made based on a history of fever, sweats, rigors, and a progressive macular rash, polyarthralgia splinter haemorrhage (limited to the left arm), and a loud left subclavian bruit on admission. A mycotic aneurysm was diagnosed by computed tomography and treated surgically. In cases of endarteritis the possibility of a mycotic aneurysm should be borne in mind even when there is no evidence of endocarditis.

Aneurysm, Infected↗
PubMed1994

Endocarditis risk of the USCI PDA umbrella for transcatheter closure of patent ductus arteriosus.

BACKGROUND: The USCI PDA Umbrella is a device to close patent ductus arteriosus (PDA) by a transcatheter technique. Human clinical trials have shown excellent efficacy in reducing or eliminating the PDA shunt, but concerns remain about the risk of infection with this device. The purpose of this study was to evaluate the risk of infection using an animal model. METHODS AND RESULTS: Susceptibility to developing endocarditis was tested by injecting a single intravenous dose of group L streptococcus. Ten piglets with a closed ductus served as controls. Two of these developed valvular vegetations. PDA was produced in 19 animals by balloon dilation of the ductus. Seven of 7 animals with PDA at the time of bacterial injection developed endarteritis of the ductus and valvular vegetations. A PDA Umbrella was placed in the remaining 12 animals, and bacteria were injected 2 weeks after device implantation. Infection was evident in the PDA Umbrella only in the single animal in which the Umbrella had embolized and been left in the left pulmonary artery. Three of the remaining 11 piglets had a significant residual leak, and all developed infection in the ductus and an additional valve. Similar to the control group, none of the animals with complete (n = 8) or nearly complete (n = 2) closure of the ductus by the PDA Umbrella had infection in or around the ductus, and only 1 had a valvular vegetation. CONCLUSIONS: In this animal model, presence of a significant PDA shunt (with or without a PDA Umbrella present) results in significantly increased susceptibility to endarteritis and endocarditis. The PDA Umbrella device does not appear to be susceptible to direct infection as early as 2 weeks after implantation if it is properly located in the ductus arteriosus. Animals with no shunt or a trivial shunt are no more susceptible to developing endocarditis 2 weeks after PDA Umbrella implantation than are controls.

Animals↗
PubMed1997

Large cerebral infarction during praziquantel therapy in neurocysticercosis.

BACKGROUND: Large cerebral infarction is a rare complication of neurocysticercosis. Endarteritis by inflammation of the leptomeninges is known to be its cause. CASE DESCRIPTION: A 59-year-old man with known neurocysticercosis developed a large cerebral infarction during praziquantel therapy. A follow-up MRI obtained immediately after his cerebral infarction demonstrated notable decrease in the size of the cysts and more prominent enhancement around the peripheral margins of the cysts and the major vessels in comparison with the initial MRI. Cerebral angiography disclosed occlusions and narrowing of both internal carotid arteries at the supraclinoid portions, where multiple cysts were found on the MRI. CONCLUSIONS: Findings in our patient strongly suggest that a secondary inflammation reaction caused by the destruction of the cysts might have enhanced the process of endarteritis. The possible deleterious effects of praziquantel therapy should be considered in the treatment of patients with subarachnoid cysticerci.

Antiplatyhelmintic Agents↗
PubMed1991

[Long term results in 70 pediatric renal transplants after more than 10 years. Histological study].

A clinicopathologic study of 41 biopsy specimens from renal grafts transplanted at least ten years earlier showed normal findings or only mild tubulointerstitial lesions in 63% of cases. Results confirmed the good prognostic value of renal graft biopsy performed ten years after transplantation. A very close correlation was demonstrated between histologic evidence of chronic rejection (interstitial fibrosis, tubular atrophy, and fibrous endarteritis) and long-term graft outcome. Severity of interstitial fibrosis was apparently a more reliable indicator of prognosis than severity of fibrous endarteritis. Among 16 patients with a history of acute rejection, none had residual parenchymatous lesions. In contrast, among patients with major tubulointerstitial and/or vascular lesions, most had previously experienced one or several episodes of acute rejection. Evidence of allograft glomerulopathy was seen in approximately one case in four (11 patients). Among these patients, only eight had proteinuria and only four lost their graft. Among the four patients who developed recurrent membranoproliferative glomerulonephritis (type I in three cases and type II in one case), three lost the deposits previously detected by immunofluorescence, probably as a result of immunosuppressive therapy.

Adolescent↗
PubMed1984

[Renal involvement in scleroderma].

Renal biopsies were carried out in 29 patients with scleroderma to study the early vascular lesions and their eventual clinical significance. Haemolytic acute renal failure was present in 9 patients. The biopsies showed early vascular lesions on interlobar arteries. The main biological change was proliferative or fibrous endarteritis. Mucoid infiltration was found in 3 biopsies. The arterioles were spared or only slightly affected without major fibrinoid necrosis. These lesions were therefore distinct from those of malignant hypertension. However, at autopsy of 2 of these cases, the vascular lesions were undistinguishable from those of malignant hypertension. The biopsies in 13 out of 14 patients with scleroderma without obvious renal involvement (9 cases) or with moderate proteinuria and/or hypertension without renal failure (5 cases) showed interlobar endarteritis with associated mucoid infiltration in 3 patients. This lesion was isolated but sometimes extensive even in young patients without hypertension. One patient died within one year, of disseminated colonic carcinoma, and 4 of cardio-respiratory failure due to scleroderma without hypertension, renal failure or proteinuria. Eight of the 9 remaining patients were traced 6 to 16 years after biopsy. Two were moderately hypertensive but none had renal failure. Cutaneous and internal organ scleroderma had regressed in the majority and proteinuria had disappeared in 3 cases.

Acute Kidney Injury↗