SYSTEMIC NECROTIZING ANGIITIS WITH ASTHMA - CAUSES AND PRECIPITATING FACTORS IN 43 CASES
SYSTEMIC NECROTIZING ANGIITIS WITH ASTHMA - CAUSES AND PRECIPITATING FACTORS IN 43 CASES
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DOI：
10.1007/bf02714432
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发表时间：
1987-01-01
期刊：
影响因子：
5
通讯作者：
ROSENTHAL, P
中科院分区：
文献类型：
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作者：
GUILLEVIN, L;GUITTARD, T;ROSENTHAL, P
在43例哮喘患者中寻找全身性坏死性血管炎（NA）的原因和促发因素，重点是疫苗接种和脱敏史。患者的平均年龄为43.2岁。诊断是基于25例患者的组织病理学结果，2例动脉造影，16例临床标准。19例患者的家族中存在过敏表现史（哮喘、鼻炎、湿疹、荨麻疹）。42例患者在发生NA之前患有哮喘，其中23例接受了类固醇治疗。19例受试者在发病前4周内有脱敏史，5例有疫苗接种史。NA的主要症状为哮喘43例，发热25例，体重减轻31例，周围神经病变29例，皮肤体征25例，消化道体征（腹痛、消化道出血、肠穿孔）16例，非感染性肺病伴肺浸润33例。嗜酸性粒细胞增多症为8，212.+-。6，214/mm3。30例患者中2例检测到HBsAg。15例NA伴哮喘患者预后良好，均痊愈出院。7名患者死亡，其他患者有所改善，但仍在接受治疗。生存曲线显示，75%的患者在60个月后仍然存活。我们的研究结果表明，不同的原因可以被认为是负责任的NA，并且，在NA与哮喘的情况下，有理由考虑疫苗接种和脱敏作为促发因素。
Causes and precipitating factors for systemic necrotizing angiitis (NA) with asthma were sought in 43 patients, focusing on a history of vaccination and desensitization. Mean age of patients was 43.2 years. Diagnosis was based on histopathologic findings in 25 patients, arteriography in 2, and clinical criteria in 16. History of allergic manifestations (asthma, rhinitis, eczema, urticaria) was present in the family of 19 patients. Forty-two patients presented with asthma before development of NA and 23 of them were treated with steroids. Nineteen subjects gave a history of desensitization and 5 of vaccination in the 4 weeks preceding the disease. The main symptoms of NA were asthma in 43, fever in 25, weight loss in 31, peripheral neuropathy in 29, cutaneous signs in 25, digestive signs in 16 (abdominal pain, digestive bleeding, bowel perforation), noninfectious pneumopathy with pulmonary infiltrates in 33. Eosinophilia was 8,212 .+-. 6,214/mm3. Antigen HBs was found in 2 of 30 patients. Prognosis of NA with asthma was good in 15 patients who recovered completely from the disease. Seven patients died and the other patients improved but remained under treatment. The survival curve showed that 75% of patients were alive after 60 months. Our findings suggest that different causes can be considered responsible for NA, and that, in cases of NA with asthma, there is reason to consider vaccination and desensitization as precipitating factors.