Skip to main content
SpringerLink
Log in

The significance of perivascular infiltrations in multiple sclerosis

  • Original Investigations
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Summary

143 autopsy cases of multiple sclerosis (19 acute and 124 chronic cases) were analysed histologically for the extent of active demyelination and the degree of infiltration within and outside the demyelinating lesions and in the leptomeninges. The results were compared with the duration of the illness. Infiltrations were found in 60% of all cases but more often (74%) in those with active demyelination. Inflammatory lesions outside demyelinating foci were observed in 27% of the total, and in 80% of them active demyelination was present. Inflammatory lesions in the meninges were present in 41% of the total and in 80% of these were accompanied by active demyelination.

The duration of illness correlated with decreasing severity of active demyelination and of perivascular infiltration. Patients treated with cortico-steroids and/or immunosuppressive substances showed no or only moderate inflammatory lesions. The duration of illness in both these groups was significantly longer than the average of untreated patients. The significance of these pathological findings for the CSF cytology in multiple sclerosis is discussed.

Zusammenfassung

143 Autopsiefälle von multipler Sklerose (19 akute und 124 chronische Fälle) wurden hinsichtlich des Grades der aktiven Entmarkung sowie der Schwere entzündlicher Infiltrate in- und außerhalb der Entmarkungsläsionen sowie in den Leptomeningen histologisch analysiert. Die Ergebnisse wurden mit der Krankheitsdauer verglichen. Infiltrate fanden sich in 60% aller Fälle mit größerer Häufigkeit (74%) bei solchen mit aktiver Entmarkung. Entzündungsläsionen außerhalb der Entmarkungsherde fanden sich bei 27% des Gesamtkollektivs, von denen 80% aktive Entmarkung zeigten. Entzündungsinfiltrate in den weichen Häuten lagen in 41% des Gesamtmaterials vor, wovon 80% mit aktiver Entmarkung einhergingen.

Die Erkrankungsdauer korrelierte mit fallender Schwere aktiver Entmarkung und perivasaler Infiltration. Mit Corticosteroiden und/oder Immunsuppressiva behandelte Patienten boten keine oder nur mäßige Entzündungsvorgänge. Die Erkrankungsdauer in diesen beiden Gruppen war signifikant höher als beim Durchschnitt der unbehandelten Patienten. Die Bedeutung dieser pathologischen Befunde für die Liquorcytologie bei multipler Sklerose wird erörtert.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Abb, L., Schaltenbrand, G.: Statistische Untersuchungen zum Problem der Multiplen Sklerose. II. Mitteilung. Das Krankheitsbild der Multiplen Sklerose. Dtsch. Z. Nervenheilk. 174, 199–218 (1955–1956)

    Google Scholar 

  • Adams, C. W. M.: The onset and progression of the lesion in multiple sclerosis. J. neurol. Sci. 25, 165–182 (1975)

    Article  CAS  PubMed  Google Scholar 

  • Alter, M., Harshe, M., Yunis, E. J.: Multiple sclerosis susceptibility and histocompability determinants. Neurology 25, 375, 489 (1975)

    Google Scholar 

  • Anton, G., Wohlwill, F.: Multiple nicht eitrige Encephalomyelitis und multiple Sklerose. Z. ges. Neurol. Psychiat. 12, 31–98 (1912)

    Article  Google Scholar 

  • Arnason, B. G. W., Chelmicka-Szorc, E.: Immunogenetic aspects of demyelinating disease. Neurology (Minneap.) 25, 489 (1975)

    CAS  PubMed  Google Scholar 

  • Arnason, B. G. W., Winkler, G. F., Hadler, N. M.: Cell-mediated demyelination of peripheral nerve in tissue culture. Lab. Invest. 21, 1–10 (1969)

    CAS  PubMed  Google Scholar 

  • Bischoff, A.: Das Vorkommen von Plasmazellen im Liquor cerebrospinalis bei der multiplen Sklerose. Dtsch. Z. Nervenheilk. 185, 606–617 (1964)

    Article  CAS  Google Scholar 

  • Bornstein, M. B., Iwanami, H.: Experimental allergic encephalomyelitis: Demyelinating activity of serum and sensitized lymph node cells on cultured nerve tissue. J. Neuropath. exp. Neurol. 30, 240–248 (1971)

    Article  CAS  PubMed  Google Scholar 

  • Dal Canto, M. C., Wisniewski, H. M., Johnson, A. B., Brostoff, S. W., Raine, C. S.: Vesicular disruption of myelin in autoimmune demyelination. J. neurol. Sci. 84, 313–319 (1975)

    Google Scholar 

  • Dubois-Dalqu, M., Schumacher, G., Worthington, E. K.: Immunoperoxydase studies on multiple sclerosis brain. Neurology (Minneap.) 25, 496 (1975)

    Google Scholar 

  • Duquette, P., Wolfgram, F.: Fractionation of the antigen that elicits the in vitro demyelinating antibodies in multiple sclerosis. Neurology (Minneap.) 25, 352 (1975)

    Google Scholar 

  • Frey, H., Bornstein, M. B., Raine, C. S., Korney, S. R.: Demyelination and immunocytolysis: Tissue culture experiments on the mechanism of demyelination. J. Ultrastruct. Res. 50, 380–381 (1975)

    Google Scholar 

  • Gaupp, R., Schroeder, F.: Über den Liquor bei der Multiplen Sklerose. Nervenarzt 12, 239–243 (1939)

    Google Scholar 

  • Harter, D. H., Yahr, M. D., Kabat, E. A.: Neurological diseases with elevation of cerebrospinal fluid gamma globulin: a critical review. Trans. Amer. neurol. Ass. 87, 210–212 (1962)

    CAS  PubMed  Google Scholar 

  • Hallervorden, J.: Anatomie und Pathogenese der Multiplen Sklerose. Münch. med. Wschr. 97, 509–518 (1955)

    CAS  PubMed  Google Scholar 

  • Jellinger, K.: Einige morphologische Aspekte der Multiplen Sklerose. Wien. Z. Nervenheilk., Suppl. II, 12–37 (1969)

  • Jellinger, K., Seitelberger, F.: Akute tödliche Entmarkungs-Enzephalitis nach wiederholten Hirntrockenzellen-Injektionen. Klin. Wschr. 36, 437–441 (1958)

    Article  CAS  PubMed  Google Scholar 

  • Jersild, C., Hansen, G. S., Fog, T., Svejgaard, A., Thomsen, M., Dupont, B.: Histocompability determinants in multiple sclerosis with special references to clinical course. Lancet 1973 II, 1221–1225

    Article  Google Scholar 

  • Lisak, R. P., Zwiman, B., Norman, M.: Antimyelin antibodies in neurologic diseases. Immunofluorescent demonstration. Arch. Neurol. (Chic.) 32, 163–167 (1975)

    CAS  PubMed  Google Scholar 

  • Lumsden, C. E.: The immunogenesis of the multiple sclerosis plaque. Brain Res. 28, 365–390 (1971)

    Article  CAS  PubMed  Google Scholar 

  • Marburg, O.: Multiple Sklerose (Encephalomyelitis periaxillaris scleroticans disseminata). In: Hdb. d. Neurol. (eds. O. Bumke, O. Foerster), Vol. 13, II, pp. 546–693. Berlin: Springer 1936

    Google Scholar 

  • Margulis, M. S.: Über die pathologische Anatomie und Pathogenese der multiplen Sklerose. Dtsch. Z. Nervenheilk. 131, 125–143 (1933)

    Article  Google Scholar 

  • Mittenecker, E.: Planung und statistische Auswertung von Experimenten, 5th ed. Wien: Deuticke 1964

    Google Scholar 

  • Myers, L. W., Ellison, G. W.: Longitudinal study of the immune response to normal human white matter in multiple sclerosis. Neurology (Minneap.) 25, 351 (1975)

    Google Scholar 

  • Oger, J. F., Arnason, B. G. W., Wray, S. H., Kistler, J. P.: A study of B and T cells in multiple sclerosis. Neurology (Minneap.) 25, 444–447 (1975)

    CAS  PubMed  Google Scholar 

  • Pette, H.: Über die Pathogenese der multiplen Sklerose. Dtsch. Z. Nervenheilk. 105, 76–132 (1928)

    Article  Google Scholar 

  • Raine, C. S., Hummelgard, A., Swanson, E., Bornstein, M. B.: Multiple sclerosis: serum induced demyelination in vitro. Light and electron microscope study. J. neurol. Sci. 20, 127–148 (1973)

    Article  CAS  PubMed  Google Scholar 

  • Raine, C. S., Schaumburg, H. H., Snyder, D. H., Dal Canto, M., Johnson, A. B., Suzuki, K.: Multiple sclerosis: ultrastructural and immunohistochemical studies of plaques from a chronic relapsing case. J. Neuropath. exp. Neurol. 34, 96 (1975)

    Google Scholar 

  • Riekinnen, U., Rinne, K., Arstila, A. U.: Neurochemical and morphological studies on demyelination in multiple sclerosis with special references to etiological aspects. Z. Neurol. 203, 91–104 (1972)

    Article  Google Scholar 

  • Sayk, J., Schmidt, R. M.: Zur Liquordiagnostik bei der multiplen Sklerose. Ärztl. Wschr. 11, 788–796 (1956)

    CAS  Google Scholar 

  • Schlote, W., Roos, W.: Gibt es ein charakteristisches Liquorzellbild bei multipler Sklerose? Nervenarzt 45, 576–587 (1974)

    CAS  PubMed  Google Scholar 

  • Sekizawa, T., Sasaki, M., Kumagi, K., Takase, S., Nakamura, S., Itahara, K.: B lymphocytes bearing immunoglobulins in multiple sclerosis. Tohoku J. exp. Med. 114, 395–397 (1974)

    Article  CAS  PubMed  Google Scholar 

  • Tourtellotte, W. W.: Cerebrospinal fluid in multiple sclerosis. Hdb. Clin. Neurol. IX, pp. 324–382. Amsterdam: Elsevier 1970

    Google Scholar 

  • Uchimura, Y., Shiraki, H.: A contribution to the classification and the pathogenesis of demyelinating encephalomyelitis. J. Neuropath. exp. Neurol. 16, 139–208 (1957)

    Article  CAS  PubMed  Google Scholar 

  • Voss, G., Jr.: Über die Liquorzytologie des frühesten Stadiums der multiplen Sklerose. Nervenarzt 12, 470–471 (1939)

    Google Scholar 

  • Wisniewski, H. M., Bloom, B. R.: Primary demyelination as a nonspecific consequence of a cell mediated immune reaction. J. exp. Med. 141, 346–359 (1975)

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology and Psychiatry, University Medical School of Pécs, Hungary

    A. Guseo & K. Jellinger

  2. Division of Special Neuropathology, Neurological Institute of University of Vienna, Austria

    A. Guseo & K. Jellinger

Authors
  1. A. Guseo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K. Jellinger
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

In memorian Erwin Neumayer, M.D. who died on February 2, 1975.

Fellow of the Bundesministerium für Wissenschaft und Forschung der Bundesrepublik Österreich.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Guseo, A., Jellinger, K. The significance of perivascular infiltrations in multiple sclerosis. J. Neurol 211, 51–60 (1975). https://doi.org/10.1007/BF00312463

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00312463

Key words

Search

Navigation