Clinical and pathological differences between skin-limited IgM/IgG vasculitis and skin-limited IgA vasculitis.
Clinical and pathological differences between skin-limited IgM/IgG vasculitis and skin-limited IgA vasculitis.
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皮肤局限性 IgM/IgG 血管炎和皮肤局限性 IgA 血管炎的临床和病理差异。
DOI：
10.1002/cia2.12156
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发表时间：
2021
影响因子：
1
通讯作者：
M.
中科院分区：
文献类型：
--
作者：
Kawamura;M. Mizutani;Y. Mizutani;Y. Matsuyama;K. Shu;E. Miyazaki;T. Seishima;M.
目的皮肤IgM/IgG血管炎（IgM/IgG V）在组织学上表现为白细胞破坏性血管炎和IgM -或IgG -血管周围沉积。然而，IgM/IgG V和皮肤局限性IgA血管炎（IgA V）的临床差异尚未完全阐明。在本研究中，我们评估了IgM/IgG V和IgA V的临床和组织病理学差异。方法我们检查了14例IgM/IgG V和24例皮肤限制性IgA V，排除与全身性疾病相关的病例。比较IgM/IgG V组和IgA V组的临床表现、实验室数据和组织学结果。结果IgM/IgG v组多出现轻微病变，可触性紫癜较少出现。IgM/IgG v组病变多局限于下肢。实验室数据显示，两组外周血计数、IgG、IgA、IgM水平比较，差异无统计学意义。组织病理学结果显示，IgM/IgG V中中性粒细胞、CD8+ T细胞、CD3+ T细胞和核尘埃的浸润较少，IgM/IgG V患者使用全身类固醇的频率明显较低，但复发率没有差异。结论基于以上结果，IgM/IgG V可能与IgA V在临床和组织学上是不同的实体，但需要进一步的研究来明确它们之间的差异。
ObjectivesCutaneous IgM/IgG vasculitis (IgM/IgG V) is characterized by leukocytoclastic vasculitis histologically and by IgM‐ or IgG‐ perivascular deposition. However, clinical differences between IgM/IgG V and skin‐limited IgA vasculitis (IgA V) have not been fully clarified. In the present study, we assessed the clinical and histopathological differences between IgM/IgG V and IgA V.MethodsWe examined 14 patients with IgM/IgG V and 24 patients with skin‐limited IgA V. The cases associated with systemic diseases were excluded. Clinical findings, laboratory data, and histological findings were compared between IgM/IgG V and IgA V groups.ResultsLivedo lesions appeared more often, and palpable purpura less often in IgM/IgG V. Localization of the lesions was more limited to the lower legs in IgM/IgG V. In laboratory data, there were no statistical differences in peripheral blood cell counts, IgG, IgA, and IgM levels between the two groups. Histopathological findings showed less infiltration of neutrophils, CD8+ T cells, and CD3+ T cells, and nuclear dusts in IgM/IgG V. Systemic steroids were administered significantly less frequently in IgM/IgG V cases, but the recurrence rate did not differ.ConclusionsBased on these results, IgM/IgG V may be a clinically and histologically different entity from IgA V. However, further studies are necessary to define the differences between them more clearly.