摘要：

A prospective study of 7 patients with systemic lupus erythematosus (S. L. E.) was carried out in order to determine the nature of the microvascular injury which characterizes this disease. A detailed evaluation of the clinical features and course and their ultrastructural correlates was made. Of 23 biopsies performed on S. L. E. patients, 12 biopsies from 5 patients contained characteristic inclusions within endothelial cells. They persisted in the same patients for up to 9 months. They were found in muscle, skin, glomerular and peritubular capillaries. They were present in all tissues actively involved by the disease process and not found in uninvolved tissues of the same patients, nonrheumatic disease patients or normal individuals. Similar inclusions were also noted in one renal biopsy from a patient with scleroderma and one renal biopsy from a patient with Goodpasture's syndrome. Immunologic studies failed to demonstrate specific myxovirus antigens in actively involved tissues, antibodies in patients' sera which were reactive with the endothelial inclusions, or unusually frequent or elevated levels of antimyxovirus antibodies in patients' sera. The significance of the inclusions is unknown, but the data suggest at least 2 major possibilities: (1) The inclusions are viral in nature and, if so, are likely to be etiologically related to S. L. E. (2) The inclusions are a reactive phenomenon on the part of the cells at the site of active disease-a reaction which occurs with a high frequency in several rheumatic diseases. In either event, the findings support the fundamental importance of microvascular injury in several rheumatic diseases.

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