Fibrinoid necrosis

Accelerated phase hypertension was previously called malignant hypertension because the lack of treatment heralded death within a year of diagnosis. It is characterised pathologically by fibrinoid necrosis of the small arteries. An important consequence is the loss of autoregulation of the cerebral and renal circulation, so that any reduction in blood pressure causes a proportional fall in perfusion of... 

Methylthioninium chloride marking of a colonic polyp resulted in an inflammatory mass with small arteries showing both segmental and circumferential fibrinoid necrosis with thrombosis (5). 

Borczuk AC, Petterino B, Alt E. Inflammatory mass with fibrinoid necrosis of vessels caused by methylene blue marking of a colonic polyp. Cardiovasc Pathol 1998 7 267-9. 

Hyalinization and fibrinoid necrosis History of hypertension, especially with diabetes. Small lesion <1 cm diameter in the distal territory of the penetrator. Often multiple, bilateral, and even symmetrically placed lesions... 

Polyarteritis nodosa Arteriolar hemorrhage Fibrinoid necrosis... 

Phosphodiesterase 4 inhibitors Vasodilator/inotrope Small- to medium-sized arteries in many organs including coronary arteries Medial fibrinoid necrosis, edema, hemorrhage, and surrounding inflammation Losco et al. (2004)... 

Inflammatory transmural angiitis in systemic lupus erythematosus, polyarteritis nodosa, or giant cell arteritis causes focal fibrinoid necrosis and elastic tissue disruption. Subacute or chronic changes usually produce ectasia and may facilitate aneurysm formation. Aneurysms in acute arteritis tend to be multiple, peripheral and non side-wall in configuration. 

In untreated diabetics, fibrinoid necrosis may be found in the vascular wall. Moreover, fluorescent-tagged insulin locates in the pancreas and the kidney, suggesting that insulin antibodies might be found at these sites. On the basis of such observation, some researchers have suggested that various forms of diabetes result from autoimmune reactions to insulin. Whether this is true remains to be established. 

Figure 2 See color insert.) Renal biopsy from a patient with MPA demonstrating crescentic glomerulonephritis with focal and segmental change and an area of fibrinoid necrosis, shown hy arrow. (Haematoxylin and Eosin x200).

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