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the localized death of living cells (as from infection or the interruption of blood supply) (同)mortification, gangrene, sphacelus

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/12/27 14:59:13」(JST)

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Micrograph showing (intensely pink) fibrinoid necrosis (large blood vessel - right of image) in a case of vasculitis (Churg-Strauss syndrome). H&E stain.

Fibrinoid necrosis is a form of necrosis, or tissue death, in which there is accumulation of amorphous, basic, proteinaceous material in the tissue matrix with a staining pattern reminiscent of fibrin. It is associated with conditions such as immune vasculitis (e.g. Henoch-Schönlein purpura), malignant hypertension, or hyperacute transplant rejection.

Fibrinoid material does usually contain fibrin and tends to be eosinophilic (staining red with the acidic dye eosin). However, in systemic lupus erythematosus the fibrinoid deposits may contain significant amounts of nuclear debris, including acidic DNA, and may be haematoxyphilic (staining purple or blue with the basic dye haematoxylin). Fibrinoid necrosis is distinguished from hyaline deposits, which are more homogeneous and glassy, and caseous necrosis, which is associated with the tuberculosis. Fibrinoid is now a somewhat historic term, based on traditional haematoxylin and eosin staining. Its significance is different in different contexts, such as malignant hypertension and rheumatoid nodules. However, in context it remains a diagnostically useful term. The idea that autoimmune diseases such as systemic lupus and rheumatoid arthritis were based on a common lesion of 'fibrinoid necrosis of collagen' led to the popular term 'collagen vascular disease', which is now obsolete. It is cells that are dead, not collagen. The presence of fibrin indicates that nearby blood vessels have become highly permeable and often themselves destroyed but vasculitis is not necessarily present at sites of fibrinoid deposition.

Fibrinoid necrosis can be associated with immune-complex associated disease, as in the synovitis and nodules of rheumatoid arthritis and various forms of immune- based vasculitis and glomerular disease. It may be associated with deposition of immune complexes and complement components in vessel walls. In small vessel vasculitis fibrin plugs frequently occur in the vessel lumen, but the term fibrinoid is usually used to refer to material outside the lumen of a vessel.^[1]Fibrinoid necrosis also occurs in the walls of arterioles in malignant hypertension (blood pressure greater than 200/130 mmHg).^[2]

Fibrinoid necrosis involves the deposition of immune complexes in areas such as the glomerulus and capillaries. The immune complexes do not cause the damage, but activate the alternative complement pathway, specifically C5a, which attracts neutrophils. The neutrophils are then responsible for causing fibrinoid necrosis.

References

^ Kumar, V., Abbas, A.K., and Fausto, N. "Robbins and Cotran Pathologic Basis of Disease" (2005). 7th ed. p. 214.
^ Kumar, V. et al. Ibid., at p. 1007.

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English Journal

Morphologic and immunohistochemical characterization of granulomas in the nucleotide oligomerization domain 2-related disorders Blau syndrome and Crohn disease.

Janssen CE, Rose CD, De Hertogh G, Martin TM, Bader Meunier B, Cimaz R, Harjacek M, Quartier P, Ten Cate R, Thomee C, Desmet VJ, Fischer A, Roskams T, Wouters CH.SourceDepartment of Pediatric Rheumatology, University Hospital Leuven, Leuven, Belgium; Department of Pathology, University Hospital Leuven, Leuven, Belgium.
The Journal of allergy and clinical immunology.J Allergy Clin Immunol.2012 Apr;129(4):1076-84.
BACKGROUND: Blau syndrome (BS) and Crohn disease (CD) are both characterized by granulomatous inflammation and related to nucleotide oligomerization domain 2 (NOD2) mutations.OBJECTIVE: This study aimed to define the morphologic and immunohistochemical characteristics of granulomas in patients with
PMID 22464675

Japanese Journal

Increased Splenic Fluorodeoxyglucose Uptake in a Patient with Granulomatous Angitis

Maruoka Hiroshi,Koga Takeharu,Takeo Masaaki,Honda Seiyo,Yuge Kentaro,Fukuda Takaaki,Aizawa Hisamichi
Internal Medicine 46(12), 909-911, 2007
… Splenectomy disclosed microaneurysms, giant cell granuloma, perivascular leukocytic infiltration with fibrinoid necrosis, consistent with granulomatous angitis. …
NAID 130000076707

Clostridium 属菌感染の関与が示唆された肉用牛の急死

清宮幸男,田村貴,高橋真紀,村上隆宏,佐々木幸治,宮崎大
日本獣医師会雑誌 = Journal of the Japan Veterinary Medical Association 59(10), 669-673, 2006-10-20
2002年の初冬に岩手県内の2農場（A、B）で牛の急死事例が発生した。A農場では肥育牛52頭中30頭が、無熱であるが横臥および重篤な呼吸困難に陥り、21頭が発病1から2日後に死亡、9頭が淘汰された。B農場では肉用成雌牛5頭中2頭が同様の症状を示し、発病2から3時間後に急死した。Closridium多価ワクチン（C.chauvoei、C.sepicum、C.novyi ype B）の接種後に本病の流 …
NAID 10020354729

Related Pictures

★リンクテーブル★

リンク元	「超急性拒絶反応」「慢性拒絶反応」「急性拒絶反応」「フィブリノイド壊死」

「超急性拒絶反応」

　　[★]

英: hyperacute rejection
関: 移植免疫、拒絶反応

移植直後から24時間以内に起こる激しい拒絶反応。
腎移植の時は、ドナーの血清とレシピエントのT細胞を使って抗体抗原反応が起きないか調べる。抗原はHLA class Iである。(HIM.1777)
移植腎で超急性拒絶反応が起こったときは次の病理像が見られる：neutrophils, immunoglobulin, and complement in vessel walls

反応機序：液性免疫。レシピエントの抗HLA抗体の存在による
治療法：臓器摘出

hyperacute rejection	Antibody mediated due to the presence of preformed antidonor antibodies in the transplant recipient. Occurs within minutes after transplantation.
acute rejection	Cell mediated due to cytotoxic T lymphocytes reacting against foreign MHCs. Occurs weeks after transplantation. Reversible with immunosuppressants such as cyclosporin and OKT3.
chronic rejection	Antibody-mediated vascular damage (fibrinoid necrosis); Occurs months to years after transplantation. Irreversible.

「慢性拒絶反応」

　　[★]

英: chronic rejection
同: 慢性拒否反応
関: 拒絶反応

hyperacute rejection	Antibody mediated due to the presence of preformed antidonor antibodies in the transplant recipient. Occurs within minutes after transplantation.
acute rejection	Cell mediated due to cytotoxic T lymphocytes reacting against foreign MHCs. Occurs weeks after transplantation. Reversible with immunosuppressants such as cyclosporin and OKT3.
chronic rejection	Antibody-mediated vascular damage (fibrinoid necrosis); Occurs months to years after transplantation. Irreversible.

「急性拒絶反応」

　　[★]

英: acute rejection

hyperacute rejection	Antibody mediated due to the presence of preformed antidonor antibodies in the transplant recipient. Occurs within minutes after transplantation.
acute rejection	Cell mediated due to cytotoxic T lymphocytes reacting against foreign MHCs. Occurs weeks after transplantation. Reversible with immunosuppressants such as cyclosporin and OKT3.
chronic rejection	Antibody-mediated vascular damage (fibrinoid necrosis); Occurs months to years after transplantation. Irreversible.

「フィブリノイド壊死」

　　[★]

英: fibrinoid necrosis
同: 類線維素壊死
関: 壊死、結節性動脈周囲炎、フィブリノイド変性

[1] Kumar, V., Abbas, A.K., and Fausto, N. "Robbins and Cotran Pathologic Basis of Disease" (2005). 7th ed. p. 214.

[2] Kumar, V. et al. Ibid., at p. 1007.

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fibrinoid necrosis