Mönckeberg’s sclerosis – crystal induced angiopathy

Bély, M.; Apáthy, Ágnes

doi:10.1556/oh.2013.29628

Cited by 4 publications

(8 citation statements)

References 6 publications

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“… 1. Tissue blocks of surgically removed specimens are fixed in 8% neutral buffered formalin (at pH 7.6 for >24 h at 20°C room temperature) [ 1 , 12 – 16 ]. 2.…”

Section: Resultsmentioning

confidence: 99%

“…Serial sections were examined without staining [ 1 , 12 – 16 ], with HE staining [ 18 ], as well as with special stains recommended in the literature, and were examined with the light microscope and under polarized light, respectively.…”

Section: Methodsmentioning

confidence: 99%

“…Legs amputated because of Mönckeberg’s sclerosis and/or atherosclerosis were studied by the authors [ 1 , 2 ]. They observed unstained tissue sections of the conventionally processed surgical specimens viewed with polarized light; variable amounts of cholesterol (CC—[C 27 H 46 O]), crystalline liquid lipid droplets (CL), calcium hydroxyapatite (HA—[Ca 5 (PO 4 ) 3 (OH)]) and calcium pyrophosphate dihydrate (CPPD—[Ca 2 P 2 O 7 .2H 2 O]) crystals were detectable.…”

Section: Introductionmentioning

confidence: 99%

“…In contrast to the classical staining methods the unstained technique is much more effective in the detection of crystals and crystalline structures of various metabolic disorders [ 1 , 12 – 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Crystal induced arthropathies—a comparative study of 40 patients with apatite rheumatism, chondrocalcinosis and primary synovial chondromatosis

Bély,

Apáthy

2024

Pathol. Oncol. Res.

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Introduction: Apatite rheumatism (AR), chondrocalcinosis (Ch-C), and primary synovial chondromatosis (prSynCh) are regarded as distinct clinical entities. The introduction of the non-staining technique by Bély and Apáthy (2013) opened a new era in the microscopic diagnosis of crystal induced diseases, allowing the analysis of MSU (monosodium urate monohydrate) HA (calcium hydroxyapatite), CPPD (calcium pyrophosphate dihydrate) crystals, cholesterol, crystalline liquid lipid droplets, and other crystals in unstained sections of conventionally proceeded (aqueous formaldehyde fixed, paraffin-embedded) tissue samples. The aim of this study was to describe the characteristic histology of crystal deposits in AR, Ch-C, and prSynCh with traditional stains and histochemical reactions comparing with unstained tissue sections according to Bély and Apáthy (2013).Patients and methods: Tissue samples of 4 with apatite rheumatism (Milwaukee syndrome), 16 with chondrocalcinosis, and 20 with clinically diagnosed primary synovial chondromatosis were analyzed.Results and conclusion: Apatite rheumatism, chondrocalcinosis, and primary synovial chondromatosis are related metabolic disorders with HA and CPPD depositions. The authors assume that AR and Ch-C are different stages of the same metabolic disorder, which differ from prSynCh in amorphous mineral production, furthermore in the production of chondroid, osteoid and/or bone. prSynCh is a defective variant of HA and CPPD induced metabolic disorders with reduced mineralization capabilities, where the deficient mineralization is replaced by chondroid and/or bone formation. The non-staining technique of Bély and Apáthy proved to be a much more effective method for the demonstration of crystals in metabolic diseases than conventional stains and histochemical reactions.

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“… 1. Tissue blocks of surgically removed specimens are fixed in 8% neutral buffered formalin (at pH 7.6 for >24 h at 20°C room temperature) [ 1 , 12 – 16 ]. 2.…”

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Crystal induced arthropathies—a comparative study of 40 patients with apatite rheumatism, chondrocalcinosis and primary synovial chondromatosis

Bély,

Apáthy

2024

Pathol. Oncol. Res.

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“…Typically, the crystals are accompanied by amorphous calcium phosphate [Ca3(PO4)2] and/or calcium carbonate [CaCO3] deposition. In surgical pathology, "non-staining" procedures were first introduced by Bély M, et al [9], which ushered in a new age for crystal diagnostics and the identification of crystals other than CPPD in cases of chondrocalcinosis and other metabolic illnesses [9]. This innovative, delicate technique works well to pinpoint the CPPD, calcium hydroxyapatite (HA) [Ca5(PO4)3(OH)], monosodium urate monohydrate (MSU) [NaC5H3N4O3•H2O]-monosodium salt of uric acid [C5H4N4O3], cholesterol (CC)[C27H46O] crystals, crystalline liquid lipid droplets (CL), furthermore, to recognize (distinguish, discover) other morphologically not identified crystals in paraffin embedded, unstained, formalin-fixed tissue sections observed under polarized light [9][10][11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

CPPD and Associated Crystals in Clinically Diagnosed Chondrocalcinosis: A Clinicopathological Study of 20 Patients

Bély

2024

J Orth Clin Res.

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Introduction: Chondrocalcinosis (Ch-C), induced by calcium pyrophosphate dihydrate crystals (CPPD) [Ca2P2O7.2H2O] is considered as a distinct metabolic disease and a well-defined clinical entity, with characteristic clinical manifestations and symptoms. This study used previously found method by the author .i.e, non-staining approach to discover crystal deposits in patients with clinically diagnosed Ch-C, to find a possible correlation between coexisting crystals, and to assess the role of coexistent crystals in inflammatory cellular processes of joints. Patients and methods: There were forty (40) surgical specimens that had been traditionally processed from 16 patients who had been clinically diagnosed with Ch-C. Results: In unstained tissue sections CPPD crystals were found in 22 of 40 samples of all 16 patients. Beside the CPPD crystals calcium hydroxyapatite (HA) [Ca5(PO4)3(OH)] crystals were found in 26 tissue samples of all 16 patients, cholesterol (CC) [C27H46O] in 23 tissue samples of 12 patients, and crystalline liquid lipid droplets (CL) in 11 tissue samples of 5 patients. More or less amorphous deposits of calcium carbonate [CaCO3] and/or calcium phosphate [Ca3(PO4)2] were present alongside CPPD and the contemporaneous crystals. There was a significant and positive correlation between prevalence of CPPD and HA. The connection between inflammatory cellular infiltration and CPPD, HA, CC or CL crystals surrounded by mineral deposits was not significant. Conclusions: The non-staining approach is a practical, low-tech way to find CPPD, HA, CC, and other crystals (with or without CL). The positive and significant correlation between CPPD and HA support the earlier premise that CPPD and HA represent basically an identical metabolic disorder). CPPD and/or HA crystals can provoke inflammatory processes responsible for the clinical symptoms, but the variable amounts of amorphous minerals enclose (isolate) the crystals, and can reduce or eliminate the inflammatory reaction. The authors assume that CC (with or without CL) is an associated phenomenon (concomitant fat metabolic malady) without direct cause of inflammation, and is not responsible for clinical symptoms of crystal induced arthropathies.

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Crystal Formation in Inflammation

Franklin

Mangan

Latz

2016

Annu. Rev. Immunol.

107

100

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The formation and accumulation of crystalline material in tissues is a hallmark of many metabolic and inflammatory conditions. The discovery that the phase transition of physiologically soluble substances to their crystalline forms can be detected by the immune system and activate innate immune pathways has revolutionized our understanding of how crystals cause inflammation. It is now appreciated that crystals are part of the pathogenesis of numerous diseases, including gout, silicosis, asbestosis, and atherosclerosis. In this review we discuss current knowledge of the complex mechanisms of crystal formation in diseased tissues and their interplay with the nutrients, metabolites, and immune cells that account for crystal-induced inflammation.

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Mönckeberg’s sclerosis – crystal induced angiopathy

Cited by 4 publications

References 6 publications

Crystal induced arthropathies—a comparative study of 40 patients with apatite rheumatism, chondrocalcinosis and primary synovial chondromatosis

Crystal induced arthropathies—a comparative study of 40 patients with apatite rheumatism, chondrocalcinosis and primary synovial chondromatosis

CPPD and Associated Crystals in Clinically Diagnosed Chondrocalcinosis: A Clinicopathological Study of 20 Patients

Crystal Formation in Inflammation

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