Summary
A preliminary study on the patho-anatomical changes of the peripheral autonomic system in diabetes mellitus is reported. Pieces from preganglionic communicating rami, thoracic sympathetic trunks and ganglion coeliacum obtained at autopsy from four diabetics were examined. The main findings were as follows:
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1.
Preganglionic communicating rami to thoracic sympathetic trunks displayed marked axonal degeneration and myelin destruction, partly of segmental characteer.
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2.
Paravertebral and prevertebral ganglions showed neuronal lesions including poor staining of Nissl substance, neuronolysis accompanied by proliferation of capsule cells, vacuolization of the cytoplasm and degenerative changes of processes.
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3.
Nutrient blood vessels of both communicating rami and ganglions displayed lesions characterized by a marked thickness of the walls staining intensely red with PAS according to McManus.
Thus, widespread histologically detectable lesions of the peripheral autonomic nervous system may occur in cases of diabetes mellitus.
Zusammenfassung
Es wird über die Resultate einer vorläufigen Untersuchung der pathologischanatomischen Veränderungen am peripheren autonomen Nervensystem in vier Fällen von Diabetes mellitus berichtet. Stückchen von präganglionären Rami communicantes, vom thoracalen orthosympathischen Grenzstrang und vom Ganglion coeliacum wurden histologisch untersucht. Die wichtigsten Resultate waren folgende:
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1.
Die präganglionären Rami communicantes nach dem thoracalen Grenzstrang zeigten eine klare Degeneration und eine Destruktion der Markscheiden, teilweise von segmentalem Charakter.
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2.
Paravertebrale wie prävertebrale Ganglia zeigten neuronale Läsionen mit schlechter Färbbarkeit der Nissl-Substanz, Neuronolysis begleitet von Proliferierung der Kapselzellen, Vakuolisierung des Zytoplasmas und degenerative Veränderungen der Ausläufer.
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3.
Die trophischen Gefäße der Rami communicantes sowie die der Ganglia wiesen Läsionen auf, die durch eine klare Verdickung ihrer Wände, die sich mit der PAS-Methode nach McManus stark rot färben ließen, gekennzeichnet waren.
Es hat sich also gezeigt, daß allgemein verbreitete, histologisch nachzuweisende Läsionen des peripheren autonomen Nervensystems in Fällen von Diabetes mellitus vorkommen können.
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Olsson, Y., Sorander, P. Changes in the sympathetic nervous system in diabetes mellitus. J. Neuro-Viscer. Relat 31, 86–95 (1968). https://doi.org/10.1007/BF02239177
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DOI: https://doi.org/10.1007/BF02239177