Fibrinoid Necrosis

What is fibrinoid necrosis?

In fibrinoid necrosis, the inside lining of your blood vessels becomes damaged. It occurs in the small arteries that carry blood to all areas of your body. When blood vessels become damaged, they can breakdown, causing lesions in the blood vessels, bleeding and bruises.

How does fibrinoid necrosis develop?

Necrosis is the death of a cell due to injury, trauma or lack of blood supply. In fibrinoid necrosis, the immune system is overly active. It releases substances that attach to the inside of blood vessels and cause harmful inflammation. This can kill the cells lining the blood vessel.

What causes fibrinoid necrosis?

Any condition that damages blood vessels can cause it. For example, extremely high blood pressure, such as malignant hypertension (or hypertensive crisis), can lead to fibrinoid necrosis.

Normal blood pressure is under 130/80. Malignant hypertension is blood pressure that is 180/120 or higher. This can cause fibrinoid necrosis in the blood vessels of the heart, brain, kidneys and other organs.

Other conditions that can cause fibrinoid necrosis include:

• Autoimmune diseases such as rheumatoid arthritis, lupus and rheumatic fever.
• Preeclampsia, a condition during pregnancy that causes high blood pressure.
• Subacute bacterial endocarditis, an infection of the heart.
• Vasculitis (inflammation of the blood vessels), such as polyarteritis nodosa and IgA vasculitis.

What are the symptoms of fibrinoid necrosis?

Because this condition damages blood vessels, the main symptom is bleeding, such as:

• Bleeding gums.
• Blood in the stool.
• Blood in the urine (hematuria).
• Bruises.
• Internal bleeding.
• Nose bleeds.

What are the complications of fibrinoid necrosis?

Complications usually have to do with the disease or condition that’s causing it. For example, in malignant hypertension, fibrinoid necrosis in the kidneys can lead to kidney failure. In lupus, fibrinoid necrosis can lead to skin lesions and heart problems that are associated with this disease.

How is fibrinoid necrosis diagnosed?

When cells die, they release a substance called fibrin. Pathologists, specialists who diagnose diseases, look at cells under a microscope. A buildup of fibrin is how they identify this condition.

To collect a tissue sample to study, a healthcare provider performs a biopsy. Biopsy procedures depend on the location:

• Skin biopsies involve shaving off a thin layer of skin or using a punch tool or incision to collect a deeper sample.
• Internal biopsies take a tissue sample from inside your body. Providers use a needle or an endoscope (a thin tube with a camera and tiny instruments at the end).

How is fibrinoid necrosis treated?

In general, there’s no standard treatment. But healthcare providers can treat bleeding. This depends on the type of bleeding and where it is in the body.

Providers can also treat the conditions that cause fibrinoid necrosis. For example, medications can lower blood pressure or suppress the immune system and limit further damage to the blood vessels.

How can I prevent fibrinoid necrosis?

Prevention relies on reducing your risk of developing the underlying conditions that cause it. Check in regularly with your provider. This is the best way to detect and address any health concerns that could lead to more serious issues.

If you know you have any of the underlying conditions that cause fibrinoid necrosis, make sure to follow your provider’s instructions.

What is the prognosis for people with fibrinoid necrosis?

It depends on how severe their underlying conditions are. Some diseases that cause fibrinoid necrosis can impact a person’s quality of life and lead to early death. In malignant hypertension, people who do not receive prompt treatment have a life expectancy of only two years.

When should I see my doctor?

If you’ve experienced damage to your blood vessels, follow-up care with your healthcare provider is essential. By following your provider’s treatment plan, you can manage your condition and prevent further damage.

A note from Cleveland Clinic

In fibrinoid necrosis your blood vessels become damaged. The conditions that cause it are serious and require close monitoring by a healthcare provider. Seeing your healthcare provider regularly can help you effectively manage your health and prevent complications from underlying conditions.