ARTERITIS

From Big Medical Encyclopedia

ARTERITIS (arteriitis; grech, arteria + - itis) — an inflammatory disease of arteries. Inflammatory diseases of vessels as the general concept carry the name of angiites or vasculites. On a current distinguish acute, subacute and chronic And.; on the nature of inflammatory process — specific and nonspecific. Process can have purulent, necrotic, productive character. Meet more often And. the mixed type — it is purulent - necrotic, productive and purulent, productive and necrotic etc. In the place of preferential localization of inflammatory process in a vascular wall distinguish endo-, meso - periarterites; when all wall is struck, speak about a panarteritis. At damage of an internal cover of a vessel inflammatory process, as a rule, is followed by thrombosis (trombarteriit). If And. proceed subacutely or chronically, the productive component of an inflammation prevails.

And. can arise as an independent general disease, at Krom defeat of arterial vessels plays the leading role in all picture of a disease. To of this kind And. belong: the nodular periarteritis (see the Periarteritis nodular) described by Kussmaul and Meyer (A. Kussmaul, R. Meier, 1866); its version described by the Burgher and Wegener (L. Buerger, 1908 — 1909; F. Wegener, 1939) — an obliterating endarteritis; a mesarteritis granulematozny giant-cell (see. Arteritis giant-cell ) and nonspecific And. — an aortic arch syndrome (see. Takayasu syndrome ).

In an origin of the listed forms A. immune giperergichesky response of immediate type has the leading value probably. Despite a nek-ry community of a pathogeny, each of forms system And. has a specific morphological and clinical picture.

System And. morphologically carry most often necrotic, productive and necrotic or purely productive character, are followed by thrombosis (necrotic trombarteriit, productive and necrotic trombarteriit, productive trombarteriit) and it is frequent formation of aneurisms.

And. also meet at sepsis, scarlet fever, diphtheria, poliomyelitis, flu; at some infectious diseases (rickettsioses, a brucellosis, syphilis, rheumatism, sepsis Jenta) they are observed as a rule. And., arising at the same infectious process, can have nonspecific and specific character (e.g., at rheumatism in walls of arteries it is possible to meet rheumatic granulomas; along with it a nonspecific productive endarteritis, and sometimes, in the expressed allergic phase of a disease — widespread necrotic arteritis and trombarteriita meets).

Experimental and numerous kliniko-anatomic observations quite proved a look that in origins widespread, preferential nonspecific, And. at the general infectious diseases immune responses of an organism — reaction of immediate hypersensitivity have the leading value.

Besides, And. of this kind are observed at a serum disease, sometimes after vaccination, at use of some medicines (e.g., sulfanamide). Close adjoin them And. at the disseminated lupus erythematosus, a dermatomyositis.

And. can develop at local inflammatory process owing to direct transition of an inflammation to a wall of an adjacent artery. Such purulent, gnoynonekrotichesky And. are observed at phlegmons (e.g., at phlegmon of the neck developing at scarlet fever — in branches of the general carotid artery; at the phlegmons of a mediastinum caused by foreign bodys — in an aorta). Ulcer and polipozno-ulcer And. (aortas, a pulmonary trunk) develop owing to transition of inflammatory process from an endocardium of valves. And. at phlegmons can conduct to an arrosion of a vessel (see. Arrosion ) and to profuse bleeding; ulcer And. — to education aneurisms (see); polypostural and trombotichesky imposings can be a source of thromboembolisms (see. Embolism ).

In the center of a specific inflammation the wall of an artery can be involved in process. E.g., at a pulmonary tuberculosis pulmonary and bronchial arteries can be affected, at tubercular meningitis — a branch of arteries of a soft meninx; the same can be observed at syphilis, an actinomycosis and other specific infections.

At it is long the existing centers of an inflammation locally there can be hron, productive endarteritis which is characterized by growth of an internal cover of a vessel. Such And. are observed at hron, tubercular meningitis, a toksoplazmozny encephalomeningitis in vessels of a meninx, at rheumatism — in vessels of heart. These And. arise owing to absorption of toxic products from the center of an inflammation or owing to immediate effect of the activator from a gleam of a vessel. The productive endarteritis can lead to an obliteration of a vessel. As a result And. any origin there is a sclerosis of arterial walls with loss of normal elasticity by them. Current, forecast and treatment of separate types And. — see the relevant articles.

See also Vasculitis .


Bibliography: Anichkov H.H. Inflammatory changes of arteries, in book: A. I. Chastnaya's apricots stalemate. anatomy, century 2, page 390, M. — L., 1940; Golosovskaya M. A. Nonspecific arteritis, Arkh. patol., t. 34, KV 1, page 40, 1972, bibliogr.; Davydovsky I. V. Pathological anatomy and pathogeny of diseases of the person, about 1, page 90, M., 1956; With to in about r-c about in M. A. Pathological anatomy of the major diseases of children's age, page 62, etc., M., 1946, bibliogr.; I r y and N of H. E. and about r N and to K. A. Nodular periarteritis, Wegener's granulomatosis, combined forms of system vasculites, M., 1970; Allen V. E., Barker N. W. a. H i η e s E. A. Peripheral vascular diseases, Philadelphia — L., 1962; Berb linger W. Schwere generalisierte Arteriitis bei Serumkrankheit des Menschen, Virchows Arch. path. Anat., Bd 318, S. 155, 1950, Bibliogr.; Frangenheim H. Zur Frage der Riesenzell-arteriitis, Zbl. allg. Path. path. Anat., Bd 88, S. 81, 1951, Bibliogr.

T. B. Ivanovskaya.

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