Tabes Dorsalis pathophysiology

Tertiary syphilis can affect almost any tissue. Approximately 80 percent of fatalities are caused by cardiovascular involvement, while most of the remaining 20 percent are from neurologic involvement. Cardiovascular problems are usually attributed to local inflammation induced by the multiplication of treponemes within the wall of the thoracic aorta. The subsequent aortitis produces complications such as aneurysms and coronary artery stenosis. Neurologic syphilis may be meningeal, meningovascular, parenchymatous, or various combinations thereof. If the parenchymatous form involves the brain, it is called generalized paresis; if it involves the spinal column, it is called tabes dorsalis. Complications of neurosyphilis include dementia, loss of proprioception, strokes, and blindness. For unclear reasons, cardiovascular syphilis is much less common than during the pre-antibiotic era. Gummas are highly destructive tertiary syphilitic lesions that usually occur in skin and bones but may also occur in other tissues. They are necrotizing granulomas with numerous lymphocytes, giant cells, and epithelioid cells, but few treponemes. A delayed hypersensitivity response to the small numbers of treponemes in the lesions may be responsible for the development of gummatous disease. Gummas also have become rare in the post-antibiotic era.

References

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

The exact pathogenesis of [disease name] is not fully understood.

OR

It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].

OR

[Pathogen name] is usually transmitted via the [transmission route] route to the human host.

OR

Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.

OR

[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].

OR

The progression to [disease name] usually involves the [molecular pathway].

OR

The pathophysiology of [disease/malignancy] depends on the histological subtype.

Pathophysiology

Pathogenesis

• It is understood that tabes dorsalis is caused by tertiary syphilis from treponema pallidum infection.
• Tabes dorsalis is a manifestation of invasion of treponema pallidum spirochetes to the dorsal column of spinal cord in tertiary syphilis.
• Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
• In tabes dorsalis, the preganglionic portion of the dorsal roots of spinal nerves is infiltrated with lymphocytes and plasma cells, and invasion of treponema pallidum spirochetes to posterior columns of the spinal cord makes it atrophic.
• [Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
• The progression to [disease name] usually involves the [molecular pathway].
• The pathophysiology of [disease/malignancy] depends on the histological subtype.

Genetics

• [Disease name] is transmitted in [mode of genetic transmission] pattern.
• Genes involved in the pathogenesis of [disease name] include [gene1], [gene2], and [gene3].
• The development of [disease name] is the result of multiple genetic mutations.

Gross Pathology

• On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

Microscopic Pathology

• On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].