The Experts below are selected from a list of 291 Experts worldwide ranked by ideXlab platform
Josep M Grau - One of the best experts on this subject based on the ideXlab platform.
-
small vessel vasculitis surrounding a spared temporal artery clinical and pathologic findings in a series of twenty eight patients
Arthritis & Rheumatism, 2001Co-Authors: Mariajose Esteban, Elias Campo, A Urbanomarquez, Carme Font, Jose Hernandezrodriguez, Josep Vallssole, Raimon Sanmarti, Francesc Cardellach, Ana Garciamartinez, Josep M GrauAbstract:Objective Occasionally, a temporal artery biopsy reveals small-vessel vasculitis (SVV) surrounding a spared temporal artery, the significance of which is unclear. We analyzed the final diagnosis in a series of patients with this condition and tried to identify histopathologic features with potential usefulness in predicting the ultimate diagnosis. Methods We performed a clinical and histopathologic review of 28 patients in whom SVV surrounding a spared temporal artery was the first histologic finding that led to the diagnosis of vasculitis. For comparison purposes, we analyzed the pattern of small vessel involvement in 30 patients with biopsy-proven giant cell arteritis (GCA). Results GCA was considered the most likely diagnosis in 12 patients, based on the absence of clinical evidence of additional organ involvement and normal findings on muscle biopsy and electrophysiologic study. Three patients had systemic necrotizing vasculitis (SNV), based on the demonstration of typical lesions on subsequent muscle, nerve, or kidney biopsy. After extensive evaluation, 4 patients remained unclassifiable. Nine patients were incompletely studied. Fibrinoid Necrosis was significantly more frequent in patients with SNV (P = 0.0022), whereas involvement of vasa vasorum was more frequent in patients classified as having GCA (P = 0.022). No differences in the pattern of small vessel involvement were found in patients with SVV surrounding a spared temporal artery who were classified as having GCA compared with patients with biopsy-proven GCA. Granulocytes were observed at similar frequency in all conditions. Conclusion SVV may be the only abnormal feature in a temporal artery biopsy and the only histologic evidence of vasculitis. The diagnosis of GCA can be reasonably established in most of these patients when there is no apparent evidence of additional organ involvement. However, when Fibrinoid Necrosis is observed or the temporal artery vasa vasorum are not involved, SNV must be extensively excluded.
-
immunohistochemical characterization of inflammatory cells and immunologic activation markers in muscle and nerve biopsy specimens from patients with systemic polyarteritis nodosa
Arthritis & Rheumatism, 1994Co-Authors: M C Cid, Elias Campo, Josep M Grau, Jordi Casademont, Blanca Collvinent, Alfons Lopezsoto, M Ingelmo, A UrbanomarquezAbstract:Objective. To investigate the phenotype of infiltrating cells in classic lesions of polyarteritis nodosa (PAN). Methods. Twenty-one muscle and 10 sural nerve biopsy samples from 24 patients with systemic PAN were studied using avidin—biotin—peroxidase and alkaline phosphatase—anti—alkaline phosphatase immunohistochemical techniques. Results. The inflammatory infiltrates consisted mainly of macrophages (41%) and T lymphocytes (41%), particularly of the CD4+ subset. Granulocytes were present in varying quantities (0–45%) and were more abundant in heavily infiltrated vessels and in those with Fibrinoid Necrosis. Dendritic cells could be identified in 4 samples. Proliferating and interleukin-2 receptor—expressing cells, present in 71% and 79% of the patients, respectively, were more frequent in untreated patients. Conclusion. T cell—mediated immune mechanisms may play a role in the development and perpetuation of PAN lesions.
Ingeborg M Bajema - One of the best experts on this subject based on the ideXlab platform.
-
determinants of outcome in anca associated glomerulonephritis a prospective clinico histopathological analysis of 96 patients
Kidney International, 2002Co-Authors: Herbert A Hauer, Ingeborg M Bajema, Jan A Bruijn, Hans C Van Houwelingen, Franco Ferrario, Laurehelene Noel, Rudiger Waldherr, David Jayne, Niels Rasmussen, Christiaan E HagenAbstract:Determinants of outcome in ANCA-associated glomerulonephritis: A prospective clinico-histopathological analysis of 96 patients. Background The predictive value of clinical and renal histological features for renal outcome in patients with anti-neutrophil cytoplasmic autoantibody (ANCA)-associated glomerulonephritis was investigated in a prospective analysis of 96 patients with ANCA-associated vasculitis, and moderate renal involvement (creatinine Methods The extent of 39 histological features in 96 biopsies (performed at entry in a clinical trial) was scored by two independent observers, according to a standardized protocol. Age, gender, diagnosis, glomerular filtration rate at entry (GFR 0 ), ANCA-specificity, proteinuria, and treatment of these 96 patients were also taken into account. Treatment was standardized and started after the biopsy was performed. End-points included renal function at 18 months (GFR 18 ), GFR 18 corrected for GFR 0 (CORGFR 18 ), and the occurrence of relapse or death. Results Parameters that most strongly correlated with GFR 18 were GFR 0 ( r = 0.67), interstitial fibrosis ( r = -0.45), glomerulosclerosis ( r = -0.37), and tubular atrophy ( r = -0.36). Parameters that most strongly correlated with CORGFR 18 were segmental ( r = 0.45) and cellular ( r = 0.30) crescents, and Fibrinoid Necrosis ( r = 0.46). None of the clinical and histological features predicted the occurrence of relapse or death. By applying a stepwise linear multiple regression analysis, we designed a formula for the estimation of renal function at 18 months: GFR 18 (mL/min) = 17 + 0.71 × GFR 0 (mL/min) + 0.34 × Fibrinoid Necrosis (%) + 0.33 × segmental crescents (%), ( r 2 = 0.60; standard deviation=19 mL/min). Our results were independent of diagnosis, ANCA-specificity, and treatment limb. Conclusions These data suggest that in ANCA-associated glomerulonephritis, GFR 0 and predominantly chronic renal lesions are potent predictors of GFR 18 . Active lesions are associated with renal function recovery and may be reversible. The formula for the estimation of GFR 18 shows that a combination of GFR 0 and renal histology is a better predictor for GFR 18 than GFR 0 only.
-
colocalization of anca antigens and Fibrinoid Necrosis in anca associated vasculitis
Kidney International, 2001Co-Authors: Ingeborg M Bajema, Christiaan E Hagen, Emile De Heer, Fokko J Van Der Woude, J A BruijnAbstract:Colocalization of ANCA-antigens and Fibrinoid Necrosis in ANCA-associated vasculitis. A variety of antineutrophil cytoplasmic auto-antibodies (ANCAs) are known to be associated with small vessel vasculitides such as Wegener's granulomatosis and microscopic polyangiitis. To visualize colocalization patterns of the Fibrinoid necrotic lesions and ANCA-antigens more accurately, we have developed a double staining technique in which an immunohistochemical staining is followed by a histological staining. Instead of using sequential biopsy slides of histologically and immunohistochemically stained sections, which may lead to an underestimation of the number and size of the lesions, our technique permits the visualization of the colocalized patterns of Fibrinoid Necrosis with an ANCA-antigen in a single slide. The double staining procedure is presented in this Technical Note.
-
what stuff is this a historical perspective on Fibrinoid Necrosis
The Journal of Pathology, 2000Co-Authors: Ingeborg M Bajema, Jan A BruijnAbstract:The salient features of systemic vasculitis are endothelial swelling, inflammatory infiltrates, and Fibrinoid Necrosis of the arterial wall. Of these three, the concept of Fibrinoid Necrosis is undoubtedly the most elusive. Is it really Necrosis, defined as unprogrammed cell death, that we are looking at? And does the adjective 'Fibrinoid', meaning fibrin-like, cover its most important attribute? In early case reports on systemic vasculitis the term was used with caution, but over the years it has grown in status to become the most characteristic histopathological manifestation of systemic vasculitis in patients with anti-neutrophil cytoplasmic antibodies (ANCA), suggesting that the clue to the auto-immune mechanisms that damage the vessel wall lies in the necrotic lesion. But what is this assumption based on? This review discusses the history of Fibrinoid Necrosis in vasculitis, focusing on the ideas that have been postulated over the years regarding this lesion. Special attention will be paid to its occurrence in the kidney in systemic vasculitis.
A Urbanomarquez - One of the best experts on this subject based on the ideXlab platform.
-
small vessel vasculitis surrounding a spared temporal artery clinical and pathologic findings in a series of twenty eight patients
Arthritis & Rheumatism, 2001Co-Authors: Mariajose Esteban, Elias Campo, A Urbanomarquez, Carme Font, Jose Hernandezrodriguez, Josep Vallssole, Raimon Sanmarti, Francesc Cardellach, Ana Garciamartinez, Josep M GrauAbstract:Objective Occasionally, a temporal artery biopsy reveals small-vessel vasculitis (SVV) surrounding a spared temporal artery, the significance of which is unclear. We analyzed the final diagnosis in a series of patients with this condition and tried to identify histopathologic features with potential usefulness in predicting the ultimate diagnosis. Methods We performed a clinical and histopathologic review of 28 patients in whom SVV surrounding a spared temporal artery was the first histologic finding that led to the diagnosis of vasculitis. For comparison purposes, we analyzed the pattern of small vessel involvement in 30 patients with biopsy-proven giant cell arteritis (GCA). Results GCA was considered the most likely diagnosis in 12 patients, based on the absence of clinical evidence of additional organ involvement and normal findings on muscle biopsy and electrophysiologic study. Three patients had systemic necrotizing vasculitis (SNV), based on the demonstration of typical lesions on subsequent muscle, nerve, or kidney biopsy. After extensive evaluation, 4 patients remained unclassifiable. Nine patients were incompletely studied. Fibrinoid Necrosis was significantly more frequent in patients with SNV (P = 0.0022), whereas involvement of vasa vasorum was more frequent in patients classified as having GCA (P = 0.022). No differences in the pattern of small vessel involvement were found in patients with SVV surrounding a spared temporal artery who were classified as having GCA compared with patients with biopsy-proven GCA. Granulocytes were observed at similar frequency in all conditions. Conclusion SVV may be the only abnormal feature in a temporal artery biopsy and the only histologic evidence of vasculitis. The diagnosis of GCA can be reasonably established in most of these patients when there is no apparent evidence of additional organ involvement. However, when Fibrinoid Necrosis is observed or the temporal artery vasa vasorum are not involved, SNV must be extensively excluded.
-
immunohistochemical characterization of inflammatory cells and immunologic activation markers in muscle and nerve biopsy specimens from patients with systemic polyarteritis nodosa
Arthritis & Rheumatism, 1994Co-Authors: M C Cid, Elias Campo, Josep M Grau, Jordi Casademont, Blanca Collvinent, Alfons Lopezsoto, M Ingelmo, A UrbanomarquezAbstract:Objective. To investigate the phenotype of infiltrating cells in classic lesions of polyarteritis nodosa (PAN). Methods. Twenty-one muscle and 10 sural nerve biopsy samples from 24 patients with systemic PAN were studied using avidin—biotin—peroxidase and alkaline phosphatase—anti—alkaline phosphatase immunohistochemical techniques. Results. The inflammatory infiltrates consisted mainly of macrophages (41%) and T lymphocytes (41%), particularly of the CD4+ subset. Granulocytes were present in varying quantities (0–45%) and were more abundant in heavily infiltrated vessels and in those with Fibrinoid Necrosis. Dendritic cells could be identified in 4 samples. Proliferating and interleukin-2 receptor—expressing cells, present in 71% and 79% of the patients, respectively, were more frequent in untreated patients. Conclusion. T cell—mediated immune mechanisms may play a role in the development and perpetuation of PAN lesions.
Elias Campo - One of the best experts on this subject based on the ideXlab platform.
-
small vessel vasculitis surrounding a spared temporal artery clinical and pathologic findings in a series of twenty eight patients
Arthritis & Rheumatism, 2001Co-Authors: Mariajose Esteban, Elias Campo, A Urbanomarquez, Carme Font, Jose Hernandezrodriguez, Josep Vallssole, Raimon Sanmarti, Francesc Cardellach, Ana Garciamartinez, Josep M GrauAbstract:Objective Occasionally, a temporal artery biopsy reveals small-vessel vasculitis (SVV) surrounding a spared temporal artery, the significance of which is unclear. We analyzed the final diagnosis in a series of patients with this condition and tried to identify histopathologic features with potential usefulness in predicting the ultimate diagnosis. Methods We performed a clinical and histopathologic review of 28 patients in whom SVV surrounding a spared temporal artery was the first histologic finding that led to the diagnosis of vasculitis. For comparison purposes, we analyzed the pattern of small vessel involvement in 30 patients with biopsy-proven giant cell arteritis (GCA). Results GCA was considered the most likely diagnosis in 12 patients, based on the absence of clinical evidence of additional organ involvement and normal findings on muscle biopsy and electrophysiologic study. Three patients had systemic necrotizing vasculitis (SNV), based on the demonstration of typical lesions on subsequent muscle, nerve, or kidney biopsy. After extensive evaluation, 4 patients remained unclassifiable. Nine patients were incompletely studied. Fibrinoid Necrosis was significantly more frequent in patients with SNV (P = 0.0022), whereas involvement of vasa vasorum was more frequent in patients classified as having GCA (P = 0.022). No differences in the pattern of small vessel involvement were found in patients with SVV surrounding a spared temporal artery who were classified as having GCA compared with patients with biopsy-proven GCA. Granulocytes were observed at similar frequency in all conditions. Conclusion SVV may be the only abnormal feature in a temporal artery biopsy and the only histologic evidence of vasculitis. The diagnosis of GCA can be reasonably established in most of these patients when there is no apparent evidence of additional organ involvement. However, when Fibrinoid Necrosis is observed or the temporal artery vasa vasorum are not involved, SNV must be extensively excluded.
-
immunohistochemical characterization of inflammatory cells and immunologic activation markers in muscle and nerve biopsy specimens from patients with systemic polyarteritis nodosa
Arthritis & Rheumatism, 1994Co-Authors: M C Cid, Elias Campo, Josep M Grau, Jordi Casademont, Blanca Collvinent, Alfons Lopezsoto, M Ingelmo, A UrbanomarquezAbstract:Objective. To investigate the phenotype of infiltrating cells in classic lesions of polyarteritis nodosa (PAN). Methods. Twenty-one muscle and 10 sural nerve biopsy samples from 24 patients with systemic PAN were studied using avidin—biotin—peroxidase and alkaline phosphatase—anti—alkaline phosphatase immunohistochemical techniques. Results. The inflammatory infiltrates consisted mainly of macrophages (41%) and T lymphocytes (41%), particularly of the CD4+ subset. Granulocytes were present in varying quantities (0–45%) and were more abundant in heavily infiltrated vessels and in those with Fibrinoid Necrosis. Dendritic cells could be identified in 4 samples. Proliferating and interleukin-2 receptor—expressing cells, present in 71% and 79% of the patients, respectively, were more frequent in untreated patients. Conclusion. T cell—mediated immune mechanisms may play a role in the development and perpetuation of PAN lesions.
Mariajose Esteban - One of the best experts on this subject based on the ideXlab platform.
-
small vessel vasculitis surrounding a spared temporal artery clinical and pathologic findings in a series of twenty eight patients
Arthritis & Rheumatism, 2001Co-Authors: Mariajose Esteban, Elias Campo, A Urbanomarquez, Carme Font, Jose Hernandezrodriguez, Josep Vallssole, Raimon Sanmarti, Francesc Cardellach, Ana Garciamartinez, Josep M GrauAbstract:Objective Occasionally, a temporal artery biopsy reveals small-vessel vasculitis (SVV) surrounding a spared temporal artery, the significance of which is unclear. We analyzed the final diagnosis in a series of patients with this condition and tried to identify histopathologic features with potential usefulness in predicting the ultimate diagnosis. Methods We performed a clinical and histopathologic review of 28 patients in whom SVV surrounding a spared temporal artery was the first histologic finding that led to the diagnosis of vasculitis. For comparison purposes, we analyzed the pattern of small vessel involvement in 30 patients with biopsy-proven giant cell arteritis (GCA). Results GCA was considered the most likely diagnosis in 12 patients, based on the absence of clinical evidence of additional organ involvement and normal findings on muscle biopsy and electrophysiologic study. Three patients had systemic necrotizing vasculitis (SNV), based on the demonstration of typical lesions on subsequent muscle, nerve, or kidney biopsy. After extensive evaluation, 4 patients remained unclassifiable. Nine patients were incompletely studied. Fibrinoid Necrosis was significantly more frequent in patients with SNV (P = 0.0022), whereas involvement of vasa vasorum was more frequent in patients classified as having GCA (P = 0.022). No differences in the pattern of small vessel involvement were found in patients with SVV surrounding a spared temporal artery who were classified as having GCA compared with patients with biopsy-proven GCA. Granulocytes were observed at similar frequency in all conditions. Conclusion SVV may be the only abnormal feature in a temporal artery biopsy and the only histologic evidence of vasculitis. The diagnosis of GCA can be reasonably established in most of these patients when there is no apparent evidence of additional organ involvement. However, when Fibrinoid Necrosis is observed or the temporal artery vasa vasorum are not involved, SNV must be extensively excluded.