Currently, what kind of diseases are not found in medicine. Connective tissue diseases, in particular hyalinosis, are no exception. This is an overgrowth in the connective tissue of hyaline, which forms dense masses that resemble cartilage. This pathology is observed in various diseases, for example, hypertension, lupus erythematosus, atherosclerosis, diabetes mellitus and so on. It is characterized by an increase in the permeability of blood vessels and body tissues, as well as impregnation of tissues with plasma proteins. At the same time, human vessels have a narrowed lumen and resemble dense tubules in their structure. This process is irreversible, but in some cases, partial resorption of hyaline is possible. In some cases, this pathology can be attributed to the physiological process of the body in the elderly and adulthood. This can be, for example, hyalinosis of the vessels of the spleen and so on.
Problem definition
Hyalinosis is a pathology in which hyaline (fibrillar protein) is deposited in the walls of blood vessels and connective tissue in the form of dense translucent masses. Hyaline, which is a protein, incorporates fibrin, plasma proteins, lipids and immunoglobulins. It is not exposed to acids, enzymes and alkalis. Currently, hyalinosis is a disease that is very common and is observed in most of the elderly, who have hypertension, hypertension or diabetes mellitus. The vessels are more affected, the connective tissue suffers to a lesser extent. With this pathology, the tissue becomes denser, so the disease is attributed to a variety of sclerosis.
The emergence and development of pathology
The morphogenesis of hyalinosis is very complex and depends on the type of pathology (blood vessels, connective tissue or serous membranes). The main thing in its formation is the destruction of cells of the fibrous structures and leakage of blood vessels as a result of pathological processes in the immune and nervous system, metabolism. At the same time, hyaline is formed from smooth muscle cells of the walls of blood vessels. In most cases, vascular hyalinosis can appear as a result of various diseases: hypertension, rheumatism, inflammatory processes, necrosis or sclerosis. As a result of sclerosis, this pathology is formed in scars and adhesions, vessel walls or is involved in the appearance of blood clots. This happens due to metabolic disorders in the connective tissue. There is also hyalinosis of the spleen capsule , in which the capsule increases in volume and is impregnated with proteins.
Vascular hyalinosis
Small arteries and areoles are exposed to this pathology. It occurs as a result of the destruction of the endothelium and cell membranes that line the walls of blood vessels. In this case, the shells of the vessels become thinner, they turn into thickened tubes with a narrowed or closed lumen. This process is most often observed in the brain, kidneys, pancreas and retina. Such a manifestation is characteristic of hypertension, diabetes mellitus and disorders of the human immune system. As a physiological process, arterial hyalinosis occurs in the elderly in the spleen.
Types of vascular hyalinosis
In medicine, it is customary to distinguish three varieties of vascular hyalinosis:
- Simple, characterized by the appearance due to the exit of plasma from the bloodstream. Often this phenomenon is observed with atherosclerosis and hypertension.
- Lipogialin, which contains lipids and is characteristic of people who suffer from diabetes.
- Complex hyalinosis, which consists of immunoglobulin, fibrin, and is typical for people with diseases of the immune system, rheumatism.
As a result of hyalinosis, nephrosclerosis develops with hypertension , the kidneys become wrinkled and have a fine-grained surface.
Effects
With vascular hyalinosis, the consequences are irreversible, so the prognosis is poor. Pathology leads to deformation and atrophy of the organ, as a result of this, its insufficiency develops, hemorrhages (stroke) appear. In case of connective tissue hyalinosis, partial resorption of hyaline is possible, therefore, to some extent, the pathological process may be reversible. This applies, for example, to the mammary glands. This pathology can also lead to organ failure. As for scars, there are no special disorders, but only a cosmetic defect.
Clinical picture
Vascular hyalinosis is not clinically manifested, the exception is damage to the vessels of the fundus, which can be determined using ophthalmoscopy. The small arteries look thickened and curved. The connective tissue that is affected by this ailment is dense, inelastic, cream in color. It is well seen in keloid scars and heart valves. With damage to the serous membranes, a thickening of the tissue is observed, it acquires a milky hue. If there is hyalinosis of the spleen or liver, then these organs will look as if they were doused with sugar glaze. In this case, the disease will be referred to as the glaze spleen or glaze liver.
Invisible picture of pathology
With this pathology, a thickening of the walls of the arteries is observed due to the accumulation of hyaline masses in them, which cover partially or completely the lumen. In this case, the renal tangles are replaced by this mass. With pathologies of the connective tissue and serous membranes, the presence of hyaline masses with blood glycoproteins is visible. The narrowing of the lumen of the vessels leads to barotrauma, which is not prevented by the reduction of the areola, since it will lose this ability. This leads to the impregnation of the tissue, which is supplied with blood, plasma, so it loses its function. Thus, renal glomerulus hyalinosis gradually develops, chronic renal failure and retinopathy appear, which leads to complete blindness. Since hyalinosis is also a pathology in the connective tissue, if it occurs in the valves of the heart, this contributes to their deformation and leads to their failure. The pathology of the serous membranes is most often detected during operations or autopsy. If it is found in the spleen or liver, this can lead to the filling of these organs with blood, stretching of their capsule and the appearance of pain. Lipoids and salts are often deposited in the tissue as a result of its decomposition into simple chemical compounds.
Diagnostics
To identify hyaline, staining with eosin is performed, while it will have a pink color. Van Gieson staining will have a result depending on the patient's age (yellow to red). Here, the dyes are fuchsin and picric acid. The appearance of hyaline in dead tissue is evidenced by cylinders in the urine, thrombotic masses and inflammatory exudate. For the purpose of diagnosis, histological studies are performed, while hyalinosis is observed in the intercellular substance of the connective tissue. Tissue necrosis occurs, which is often accompanied by rupture of the vascular wall, the appearance of hemorrhages and thrombosis. Under the microscope, you can detect swelling of collagen fibers, atrophy of cells, loss of vascular elasticity, compaction of organs, discoloration. Externally, the tissues that are affected by hyalinosis are not changed.
Differential diagnosis
It is necessary to distinguish between physiological hyalinosis, which appears as a result of the aging of the body, and the pathological process. The transformation of dead tissues and secretion products is also similar to this ailment. It must be remembered that pathological processes in the uterus and mammary glands are reversible, since the functions of these organs are enhanced.
Forecast
The outcome of segmental hyalinosis is renal failure. In rare cases, nephrotic syndrome is observed, which is inherited. Jade is often combined with pathologies of the development of the kidneys. Children mainly die due to insufficiency of this organ.
Thus, hyalinosis is a change in connective tissue that leads to pathologies and is the result of various diseases. Also, this process is observed during the aging of the body and is physiological in nature.