Fibrinoid necrosis: Description, Causes and Risk Factors:Necrosis in which the necrotic tissue has some staining reactions resembling fibrin and becomes deeply eosinophilic, homogenous, and refractile.Fibrinoid necrosis is a morphological pattern of necrosis characterized by the presence of an amorphous eosinophilic material reminiscent of fibrin within the area of cell death. It should be pointed out that although fibrin is a significant component of the eosinophilic material although other substances may also be present.Fibrinoid necrosis typically occurs when there is necrosis of interstitial collagen or blood vessels (small arteries or arterioles). This occurs in some autoimmune diseases such as active rheumatoid arthritis or polyarteritis nodosa. The injury that occurs to blood vessel walls in patients with malignant hypertension is an example of fibrinoid necrosis in a non-autoimmune disease.Fibrinoid necrosis also occurs in injured small vessels, in which the insudation and accumulation of a fibrin-like material (plasma proteins) cause the vessel wall to stain intensely with eosin. This can occur in cases of malignant hypertension, which causes inflammation of the vessel walls. Immune complexes are then deposited, evoking fibrinoid necrosis.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 hematoxylin and eosin staining (H&E). 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 (RA) 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.Research: Fibrinoid necrosis in previous investigations was demonstrated in the epithelial cells of the skin and of the liver in certain disorders may also appear in the colloid bodies in lichen planus. Trichrome stainings were positive for fibrinoid, staining reactions with hematoxylin variants indicated the presence of keratin and precursors, and investigations in Wood's light permitted conclusions concerning the appearance of mixed proteins, of which keratofibrinoid seems to be the most important. Circulatory disturbances are emphasized as having an important role. The colloid bodies are extruded from the epidermis, according to the observations of Kerr following the rules of apoptosis.
Fibrinoid necrosis symptoms:
Symptoms may include, but not limited to,Bruises.
Bleeding from the gums.
Rupture of the spleen and hemorrhage in the spleen.
Hemarthrosis and muscle hematoma.
Menorrhagia and postpartum hemorrhage.
Traumatic and surgical bleeding.
Diagnosis:In fibrinoid necrosis, tissues usually appear eosinophilic (pink with H&E stains) and they lose their structural details (they become amorphous). The term "fibrinoid necrosis" is used to describe this appearance because it resembles deposits of the blood clotting protein, fibrin.Reference has been made to differences in the chemical composition of the fibrinoid substance and to relations to other related substances (amyloid, keratin, and fibrin). The importance of fluorescence microscopic invesitgations with fluorochromes, using Novelli's method, and with certain other procedures is emphasized.Treatment:There is no known treatment. Treatment is basically symptomatic. The most frequently used treatment is fibrinogen concentrate. The concentrate is obtained from human plasma and contains fibrinogen only. The concentrate undergoes a viral inactivation process, which eliminates viruses such as HIV and hepatitis A, B and C.NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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