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Histochemical and electron microscopic observations on “onion bulb” formations in a case of hypertrophic neuritis of 25 years duration with onset in childhood

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Summary

Histochemical and electron microscopic data are presented from a patient with hypertrophic neuritis of 25 years duration with onset in childhood. The present observations and those of recent investigators form the basis of a discussion of various pathogenetic hypotheses for “onion bulb” structures in the nerves from patients with hypertrophic neuritis. It is concluded that the onion bulb lesion is a nonspecific manifestation of chronic segmental demyelinization resulting from a primary or acquired abnormality of Schwann cells.

Zusammenfassung

Histochemische und elektronenoptische Befunde eines Patienten mit hypertrophischer Neuritis von 25 Jahren Dauer mit Beginn der Erkrankung in der Kindheit werden mitgeteilt. Die erhobenen Befunde sowie andere jüngste Beobachtungen bilden die Grundlage einer Diskussion der verschiedenen pathogenetischen Hypothesen der “Zwiebelschalen”-Strukturen in den Nerven von Patienten mit hypertrophischer Neuritis. Die Zwiebelschalenbildung wird als unspezifische Manifestation einer chronischen segmentalen Entmarkung infolge primärer oder erworbener Anomalie der Schwann-Zellen interpretiert.

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References

  • Achard, E., etJ. Thiers: Polynévrite Chronique Hypertrophique de l'adulte. Rev. neurol.3, 146–150 (1924).

    Google Scholar 

  • Aitkin, J. T., M. Sharman, andJ. Z. Young: Maturation of regenerating nerve fibers with various peripheral connexions. J. Anat. (Lond.)81, 1–22 (1947).

    Google Scholar 

  • Austin, J. H.: Observations on the syndrome of hypertrophic neuritis. (The hypertrophic interstitial radiculo-neuropathies). Medicine (Baltimore)35, 187–239 (1956).

    Google Scholar 

  • Bielschowsky, M.: Familiäre hypertrophische Neuritis und Neurofibromatose. J. Psychol. Neurol. (Lpz.)24, 182–205 (1922).

    Google Scholar 

  • Boveri, P.: De la Névrite Hypertrophique Familiale. Sem. méd. (Paris)30, 145–150 (1910).

    Google Scholar 

  • Cammermeyer, J.: Neuropathologic changes in hereditary neuropathies: Manifestations of the syndrome heredopathia atactica polyneuritiformes in the presence of interstitial hypertrophic polyneuropathy. J. Neuropath. exp. Neurol.15, 340–361 (1956).

    Google Scholar 

  • Dalton, A. J.: A chrome-osmium fixative for electron microscopy. Anat. Rec.121, 281 (1955).

    Google Scholar 

  • DeBruyn, R. S., andR. O. Stern: A case of the progressive hypertrophic polyneuritis of Déjérine and Sottas with pathological examination. Brain52, 84–107 (1929).

    Google Scholar 

  • Dejerine, J., etJ. Sottas: Sur la névrite interstitielle hypertrophique et progressive de l'enfance. C. R. Soc. Biol. (Paris)45, 63–96 (1893).

    Google Scholar 

  • —, etA. Thomas: Névrite interstitielle et hypertrophique de l'enfance. Nouv. Incon. Salpètr.19, 477–509 (1906).

    Google Scholar 

  • Dereux, J.: La maladie de Refsum. Rev. neurol.109, 599–608 (1963).

    Google Scholar 

  • Dinkler: Zur Kasuistik der multiplen Herdsklerose des Gehirns und Rückenmarks. Dtsch. Z. Nervenheilk.26, 233–247 (1904).

    Google Scholar 

  • Dyck, P. J.: Histologic measurements and fine structure of biopsied sural nerve: normal, and in peroneal muscular atrophy, hypertrophic neuropathy, and congenital sensory neuropathy. Proc. Mayo Clin.41, 742–774 (1966).

    Google Scholar 

  • Engle, W. K., andG. C. Cunningham: Rapid examination of muscle tissue. Neurology (Minneap.)13, 919–923 (1963).

    Google Scholar 

  • Evans, D. H. L., andJ. G. Murray: A study of regeneration in a motor nerve with a unimodal fiber diameter distribution. Anat. Rec.126, 311 (1956).

    Google Scholar 

  • Farber, E., W. H. Sternberg, andC. E. Dunlap: Histochemical localization of specific oxidative enzymes. J. Histochem. Cytochem.4, 254–284 (1956).

    Google Scholar 

  • Glimstedt, G., andG. Wohlfart: Electron microscopic studies of peripheral nerve regeneration. Lunds. Arsskr. N. F. Avd.56, 16 (1960).

    Google Scholar 

  • Gombault, A., etMallet: Un cas de tabès. Arch. Méd. exp.1, 385–415 (1889).

    Google Scholar 

  • Green, L. N., I. Herzog, andD. Aberfeld: A case of hypertrophic neuritis coexisting with dementia and cerebellar degeneration. J. Neuropath. exp. Neurol.24, 682 (1965).

    Google Scholar 

  • Harris, W., andW. D. Newcomb: A case of relapsing interstitial hypertrophic neuritis. Brain52, 108–116 (1929).

    Google Scholar 

  • Hess, A.: The fine structure and morphological organization of non-myelinated nerve fibers. Proc. roy. Soc. B144, 496–506 (1956).

    Google Scholar 

  • Huyley, H. E., andC. Zubay: Preferential staining of nucleic acid containing structures for electron microscopy. J. biophys. biochem. Cytol.11, 273–296 (1961).

    Google Scholar 

  • Klenk, E., u.W. Kahlke: Über das Vorkommen der 3,7,11,15-Tetramethylhexadecansaure (Phytansäure) in den Cholesterinestern und anderen Lipidfraktionen der Organe bei einem Krankheitsfall unbekannter Genese (Verdacht auf Heredopathia atactica polyneuritiformis — Refsum-Syndrome). Hoppe-Seylers Z. physiol. Chem.333, 133–139 (1963).

    Google Scholar 

  • Krücke, W.: Die mucoide Degeneration der peripheren Nerven. Virchows Arch. path. Anat.304, 442–463 (1939).

    Google Scholar 

  • Long, E.: Atrophie musculaire progressive type Aran-Duchenne de nature névritique. Nouv. Incon. Sapètr.25, 281 (1912).

    Google Scholar 

  • Luft, J. H.: Improvement in epoxy resin embedding methods. J. biochem. biophysic. Cytol.9, 408–414 (1961).

    Google Scholar 

  • Manheimer, L. H., andA. M. Seligman: Improvement in the method for the histochemical demonstration of alkaline phosphatase and its use in a study of normal and neoplastic tissues. J. nat. Cancer Inst.9, 181–199 (1948).

    Google Scholar 

  • Marie, M. P.: Forme speciale de névrite interstitielle hypertrophique progressive de l'enfance. Rev. neurol.14, 557–560 (1906).

    Google Scholar 

  • Marie, P., etI. Bertrand: Contribution à l'anatomie pathologique de la névrite hypertrophique familiale. Ann. Méd.5, 209 (1918).

    Google Scholar 

  • Masson, P.: Experimental and spontaneous Schwannomas (peripheral gliomas). Amer. J. Path.8, 368–388 (1932).

    Google Scholar 

  • Nachlas, M. M., andA. M. Seligman: The histochemical demonstration of esterase. J. nat. Cancer Inst.8, 415–425 (1949).

    Google Scholar 

  • —,K. C. Tsou, E. De Souza, C. S. Cheng, andA. M. Seligman: Cytochemical demonstration of succinic dehydrogenase by the use of a new p-nitrophenyl substituted dietetrazole. J. Histochem. Cytochem.5, 420–425 (1957).

    Google Scholar 

  • Nageotte, J.: Sheaths of the peripheral nerves: Nerve degeneration and regeneration, vol. I, pp. 189–240. In:Penfield, W.: Cytol. and Cell Path. New York: P. B. Hoeber, Inc. 1932.

    Google Scholar 

  • Nathaniel, E. J. H., andD. C. Pease: Collagen and basement membrane formation by schwann cells during nerve regeneration. J. Ultrastruct. Res.9, 550–560 (1963).

    Google Scholar 

  • Reynolds, E. S.: The use of lead citrate in electron microscopy. J. Cell Biol.17, 208 (1963).

    Google Scholar 

  • Seligman, A. M., K. C. Tsou, R. B. Cohen, andS. H. Rutenberg: Histochemical demonstration of β-D-glucuronidase with a synthetic substrate. J. Histochem. Cytochem.2, 209–229 (1954).

    Google Scholar 

  • Russell, W. R., andH. G. Garland: Progressive hypertrophic polyneuritis with case reports. Brain53, 376–384 (1930).

    Google Scholar 

  • Shanthaveerappa, T. R., andG. H. Bourne: Perineural epithelium: A new concept of its role in the integrity of the peripheral nervous system. Science154, 1464–1467 (1966).

    Google Scholar 

  • Slauck, D. S.: Neuritis interstitialis bzw. Hypertrophica progressiva. Klin. Wschr.8, 927–929 (1929).

    Google Scholar 

  • Sorgo, J.: Zur Histologie und Klinik der Neurofibrome nebst Bemerkungen über das Verhalten der Patellarreflexe bei Querschnittsläsionen des Rückenmarkes im unteren Brustmark. Virchows Arch. path. Anat.170, 399–428 (1902).

    Google Scholar 

  • Thomas, P. K.: Changes in the endoneurial sheaths of peripheral myelinated nerve fibers during Wallerian degeneration. J. Anat. (Lond.)98, 175–182 (1964).

    Google Scholar 

  • Thomas, P. K. andR. G. Lascelles: Schwann cell abnormalities in diabetic neuropathy. Lancet1965 I, 1335–1357.

  • ——: Hypertrophic neuropathy. Quart. J. Med. (N.S.)36, 223–237 (1967).

    Google Scholar 

  • Wachstein, M., andE. Meisel: Histochemistry of hepatic phosphatases at physiologic pH. Amer. J. clin. Path.27, 13–23 (1957).

    Google Scholar 

  • Webster, H. de F., J. M. Schröder, A. K. Asbury, andR. D. Adams: The role of Schwann cells in the formation of “onion bulbs” found in chronic neuropathies. J. Neuropath. exp. Neurol.26, 276–299 (1967).

    Google Scholar 

  • Weiss, P., M. V. Edds, Jr., andM. Cavanaugh: The effect of terminal connections on the caliber of nerve fibers. Anat. Rec.92, 215–233 (1945).

    Google Scholar 

  • Weller, R. O.: An electron microscopic study of hypertrophic neuropathy of Déjérine and Sottas. J. Neurol. Neurosurg. Psychiat.30, 111–125 (1967).

    Google Scholar 

  • Wood, G. C.: The formation of fibrils from collagen solutions III. Effect of chondroitin sulphate and some other naturally occurring polyanions on the rate of formation. Biochem. J.75, 605–612 (1960).

    Google Scholar 

  • Wolf, A., A. H. Rubinowitz, andS. C. Burchell: Interstitial hypertrophic neuritis of Déjérine and Sottas. Report of three cares. Bull. Neurol. Inst. N.Y.2, 373–428 (1932).

    Google Scholar 

  • Yokomori, K.: Über Neuritis interstitialis hypertrophica et progressiva (Déjérine u. Sottas) mit einem Sektionsbefund. Mitt. Medizin. Fak. Kaiserl. Univers. Tokyo15, 1–48 (1916).

    Google Scholar 

  • Zacks, S. I.: Histochemical and ultrastructure observations on “Hyalin degeneration” in severely atrophic muscle. J. Histochem. Cytochem. (Abstr.) (1967).

  • Zacks, S. I., H. Lipshutz, S. Malkind andF. A. Elliott: Hyaline degeneration in severely atrophic muscle. Histochemical and electron microscopic observations. Brain (in press).

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Zacks, S.I., Lipshutz, H. & Elliott, F. Histochemical and electron microscopic observations on “onion bulb” formations in a case of hypertrophic neuritis of 25 years duration with onset in childhood. Acta Neuropathol 11, 157–173 (1968). https://doi.org/10.1007/BF00690218

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