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Distinctive Pathologic Findings in Proximal Diabetic Neuropathy (Diabetic Amyotrophy) Neurol 55:83-88, Kelkar,P. et al, 2000 See this aricle in Pubmed Article Abstract Four patients showed the distinctive findings of polymorphonuclear small-vessel vasculitis affecting epineurial vessels with transmural infiltration of postcapillary venules with polymorphonuclear leukocytes. Immunoglobulin M (IgM) deposits were found along the endothelium and intramurally in affected vessels. IgM staining was seen in the subperineurial space and in the endoneurium. Activated complement deposition was seen along endothelium of small vessels. Three of these four patients were evaluated within 6 weeks of onset of PDN, and the fourth patient during acute flare of PDN 6 months after the initial onset. Six patients showed "perivasculitis" with mononuclear cell infiltrates around small epineurial vessels without vasculitis (fibrinoid necrosis or transmural inflammation). One patient showed recanalized vessels with transmural lymphocytes without fibrinoid necrosis, possibly suggesting healed vasculitis. These distinctive pathologic findings support that proximal diabetic neuropathy has an immune-mediated inflammatory basis and suggest that polymorphonuclear vasculitis with immune complex and complement deposition may be the primary even in the acute phase of proximal diabetic neuropathy.

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(click to filter results - removes previous filter) diabetes mellitus diabetes mellitus,neurologic manifestations of diabetic amyotrophy nerve biopsy neuropathology neuropathology,peripheral nerves neuropathy neuropathy,diabetic neuropathy,vasculitic,nonsystemic pathology vasculitides

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