Skip to main content
PMC home page
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1993 Jan;46(1):37–40. doi: 10.1136/jcp.46.1.37

Intramural platelet deposition in cerebral vasculopathy of systemic lupus erythematosus.

D Ellison 1, K Gatter 1, A Heryet 1, M Esiri 1
PMCID: PMC501110  PMID: 8432885

Abstract

AIMS: To test the hypothesis that fragments of platelet thrombi and vascular endothelium are incorporated into the walls of small cerebral vessels in systemic lupus erythematosus (SLE). METHODS: Six varied necropsy cases of central nervous system (CNS) SLE and 15 controls were studied. The controls were selected to represent a wide range of diseases in which the cerebral circulation is compromised. Tissue sections were stained by standard histochemical and immunocytochemical methods, the latter using antibodies to platelet membrane glycoprotein IIIa (CD61), and vascular endothelium (CD31). RESULTS: In four of six cases of CNS SLE characterised by small vessel hyalinization and thickening, fragments of platelet membrane were found in the walls of small cortical and meningeal vessels. Similar findings were not evident in two other SLE cases that were characterised by relatively short clinical histories and an acute vasculitis. One control case of severe polyarteritis nodosa showed platelet fragment deposition in arteries larger than the vessels so affected in SLE. CONCLUSIONS: Previous studies have suggested that neuropsychiatric symptoms in SLE may be related to repeated episodes of vasculitis in small cerebral vessels that are triggered by antiphospholipid antibodies. Concurrent thrombus formation might facilitate the incorporation of platelet fragments into small vessel walls. This process contributes to the thickening and irregularity of small vessels, a major feature of longstanding cases of CNS SLE.

Full text

PDF
37

Images in this article

38Image
on p.38
38Image
on p.38
39Image
on p.39
39Image
on p.39
39Image
on p.39
40Image
on p.40

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Angles-Cano E. Endothelial damage and hypofibrinolysis in systemic lupus erythematosus. Thromb Haemost. 1989 Apr 25;61(2):322–322. [PubMed] [Google Scholar]
  2. Asherson R. A., Khamashta M. A., Gil A., Vazquez J. J., Chan O., Baguley E., Hughes G. R. Cerebrovascular disease and antiphospholipid antibodies in systemic lupus erythematosus, lupus-like disease, and the primary antiphospholipid syndrome. Am J Med. 1989 Apr;86(4):391–399. doi: 10.1016/0002-9343(89)90335-5. [DOI] [PubMed] [Google Scholar]
  3. Asherson R. A., Lubbe W. F. Cerebral and valve lesions in SLE: association with antiphospholipid antibodies. J Rheumatol. 1988 Apr;15(4):539–543. [PubMed] [Google Scholar]
  4. Bluestein H. G. Neuropsychiatric manifestations of systemic lupus erythematosus. N Engl J Med. 1987 Jul 30;317(5):309–311. doi: 10.1056/NEJM198707303170509. [DOI] [PubMed] [Google Scholar]
  5. Cines D. B., Lyss A. P., Reeber M., Bina M., DeHoratius R. J. Presence of complement-fixing anti-endothelial cell antibodies in systemic lupus erythematosus. J Clin Invest. 1984 Mar;73(3):611–625. doi: 10.1172/JCI111251. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Cordell J. L., Falini B., Erber W. N., Ghosh A. K., Abdulaziz Z., MacDonald S., Pulford K. A., Stein H., Mason D. Y. Immunoenzymatic labeling of monoclonal antibodies using immune complexes of alkaline phosphatase and monoclonal anti-alkaline phosphatase (APAAP complexes). J Histochem Cytochem. 1984 Feb;32(2):219–229. doi: 10.1177/32.2.6198355. [DOI] [PubMed] [Google Scholar]
  7. Ellis S. G., Verity M. A. Central nervous system involvement in systemic lupus erythematosus: a review of neuropathologic findings in 57 cases, 1955--1977. Semin Arthritis Rheum. 1979 Feb;8(3):212–221. doi: 10.1016/s0049-0172(79)80009-8. [DOI] [PubMed] [Google Scholar]
  8. Fuster V., Badimon L., Badimon J. J., Chesebro J. H. The pathogenesis of coronary artery disease and the acute coronary syndromes (1). N Engl J Med. 1992 Jan 23;326(4):242–250. doi: 10.1056/NEJM199201233260406. [DOI] [PubMed] [Google Scholar]
  9. Gatter K. C., Cordell J. L., Turley H., Heryet A., Kieffer N., Anstee D. J., Mason D. Y. The immunohistological detection of platelets, megakaryocytes and thrombi in routinely processed specimens. Histopathology. 1988 Sep;13(3):257–267. doi: 10.1111/j.1365-2559.1988.tb02037.x. [DOI] [PubMed] [Google Scholar]
  10. Hopkins P., Belmont H. M., Buyon J., Philips M., Weissmann G., Abramson S. B. Increased levels of plasma anaphylatoxins in systemic lupus erythematosus predict flares of the disease and may elicit vascular injury in lupus cerebritis. Arthritis Rheum. 1988 May;31(5):632–641. doi: 10.1002/art.1780310508. [DOI] [PubMed] [Google Scholar]
  11. How A., Dent P. B., Liao S. K., Denburg J. A. Antineuronal antibodies in neuropsychiatric systemic lupus erythematosus. Arthritis Rheum. 1985 Jul;28(7):789–795. doi: 10.1002/art.1780280710. [DOI] [PubMed] [Google Scholar]
  12. Jafar J. J., Menoni R., Feinberg H., LeBreton G., Crowell R. M. Selective platelet deposition during focal cerebral ischemia in cats. Stroke. 1989 May;20(5):664–667. doi: 10.1161/01.str.20.5.664. [DOI] [PubMed] [Google Scholar]
  13. Johnson R. T., Richardson E. P. The neurological manifestations of systemic lupus erythematosus. Medicine (Baltimore) 1968 Jul;47(4):337–369. doi: 10.1097/00005792-196807000-00002. [DOI] [PubMed] [Google Scholar]
  14. Kushner M. J., Tobin M., Fazekas F., Chawluk J., Jamieson D., Freundlich B., Grenell S., Freemen L., Reivich M. Cerebral blood flow variations in CNS lupus. Neurology. 1990 Jan;40(1):99–102. doi: 10.1212/wnl.40.1.99. [DOI] [PubMed] [Google Scholar]
  15. Lim L., Ron M. A., Ormerod I. E., David J., Miller D. H., Logsdail S. J., Walport M. J., Harding A. E. Psychiatric and neurological manifestations in systemic lupus erythematosus. Q J Med. 1988 Jan;66(249):27–38. [PubMed] [Google Scholar]
  16. O'Connor J. F., Musher D. M. Central nervous system involvement in systemic lupus erythematosus. A study of 150 cases. Arch Neurol. 1966 Feb;14(2):157–164. doi: 10.1001/archneur.1966.00470080041006. [DOI] [PubMed] [Google Scholar]
  17. Parums D. V., Cordell J. L., Micklem K., Heryet A. R., Gatter K. C., Mason D. Y. JC70: a new monoclonal antibody that detects vascular endothelium associated antigen on routinely processed tissue sections. J Clin Pathol. 1990 Sep;43(9):752–757. doi: 10.1136/jcp.43.9.752. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Tan E. M., Cohen A. S., Fries J. F., Masi A. T., McShane D. J., Rothfield N. F., Schaller J. G., Talal N., Winchester R. J. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982 Nov;25(11):1271–1277. doi: 10.1002/art.1780251101. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES