Simultaneous Combined Myositis, Inflammatory Polyneuropathy, and Overlap Myasthenic Syndrome

Figure 1

Pathological findings in patient 1. (a) Transverse semithin section of sural nerve stained with Toluidine Blue: there is a moderate loss of myelinated fibers. Only a few fibers have a too thin myelin sheath compared to their axonal diameter. (b) Frozen section of deltoid muscle stained with hematein-eosin showing important infiltrates of mononuclear cells; the immunostaining confirmed that these cells were mostly T cells and macrophages. (c) Electron micrograph of a sural nerve section showing two fibers surrounded by onion bulb formation and a fiber with a thin myelin sheath. (d) Electron micrograph of a sural nerve section showing an axon that has been completely demyelinated.

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