Aschoff knot

This article covers rheumatic granuloma; for the part of the conduction system of the heart (Aschoff-Tawara node) see atrioventricular node .

Aschoff node in the myocardium , the centrally located cell nuclei of the myocytes can be clearly seen

Classification according to ICD-10
I09.0	Rheumatic myocarditis
ICD-10 online (WHO version 2019)

The Aschoff lump is a rheumatic granuloma that can occur in the context of pancarditis with rheumatic fever . It was first described in 1904 by Ludwig Aschoff and a year later by Paul Rudolf Geipel . In the German literature, they are therefore described as Aschoff-Geipel nodes , in Russian-speaking countries they are synonymous with Aschoff-Talajew nodes .

pathology

The Aschoff lumps only occur in acute rheumatic fever . These are periarterial granulomas that occur particularly in the interstitium of the heart muscles.

Pathogenesis

Rheumatic fever is usually preceded by a pharyngeal infection with β-haemolytic streptococci of Lancefield group  A ( Streptococcus pyogenes ). The specific M protein (usually with the serotype M 1, 3, 5 or 18) of the capsule substance of the streptococci has antigenic properties . In the course of the immune response, antibodies against the M protein are formed; these antibodies show cross- antigenicity towards sarcolemmal myosin and tropomyosin . Antibodies against hyaluronic acid and autoantibodies against proteoglycans of the connective tissue were also detected.

histology

The Aschoff nodules appear in the vicinity of the small myocardial arteries , they arise in three steps:

1. Exudative phase
2. Granulomatous phase
3. Scarring

Individual evidence

1. ↑ Alphabetical directory for the ICD-10-WHO version 2019, volume 3. German Institute for Medical Documentation and Information (DIMDI), Cologne, 2019, p. 82
2. ^ Zetkin, Schaldach: Lexicon of Medicine. 16th edition. Ullstein-Medical, ISBN 3-86126-126-X .
3. ↑ Cunningham et al .: Human monoclonal antibodies reactive with antigens of the group A Streptococcus and human heart . In: J Immunol. 1988 Oct 15; 141 (8), pp. 2760-2766. PMID 3049816
4. ↑ Wessels et al .: Hyaluronic acid capsule is a virulence factor for mucoid group A streptococci . In: Proc Natl Acad Sci U.S.A. 1991 Oct 1; 88 (19), pp. 8317-8321. PMID 1656437

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !