Henoch-Schönlein purpura: clinicopathologic correlation of cutaneous vascular IgA deposits and the relationship to leukocytoclastic vasculitis.
Henoch-Schönlein purpura: clinicopathologic correlation of cutaneous vascular IgA deposits and the relationship to leukocytoclastic vasculitis.
复制标题
过敏性紫癜：皮肤血管 IgA 沉积的临床病理学相关性及其与白细胞破碎性血管炎的关系。
DOI：
10.2340/0001555575125129
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发表时间：
1995
影响因子：
3.6
通讯作者：
L. Gibson
中科院分区：
文献类型：
--
作者：
S. D. Helander;F. de Castro;L. Gibson
显著的皮肤血管伊加沉积在过敏性紫癜中很常见，但在其他血管炎中不常见。过敏性紫癜伊加血管沉积的特异性尚未明确。为了研究伊加血管沉积对这种疾病的特异性，我们比较了92例伊加血管沉积和直接免疫荧光血管炎印象与90例无伊加沉积的类似病例的临床病理特征。在直接免疫荧光检查中，24%的血管伊加沉积病例被诊断为过敏性紫癜。伊加沉积常见于结节性红斑和静脉瘀血相关问题，以及冷球蛋白血症、凝血病性血管病和青斑样血管炎。在我们的病例中，78%的病例表现出血管荧光与多种缀合物。单独的组织学或免疫荧光模式没有特异性。如果存在胃肠道受累、上呼吸道感染或年龄< 20岁，则过敏性紫癜的诊断特异性提高。我们提出了过敏性紫癜的诊断标准，结合临床表现，敏感性和特异性> 90%。
Significant cutaneous vascular IgA deposits are common in Henoch-Schönlein purpura but not in other vasculitides. The specificity for IgA vascular deposits for Henoch-Schönlein purpura is not well defined. To examine the specificity of IgA vascular deposits for this disease, we compared clinicopathologic features of 92 cases with IgA vascular deposits and a direct immunofluorescence impression of vasculitis with 90 similar cases without IgA deposits. Henoch-Schönlein purpura was diagnosed in 24% of cases with vascular IgA deposits on direct immunofluorescence examination. IgA deposits were frequent in erythema nodosum and venous stasis-related problems and in cryoglobulinemia, coagulopathic vasculopathies, and livedoid vasculitis. Of our cases, 78% exhibited vascular fluorescence with multiple conjugates. No histologic or immunofluorescence pattern alone was specific. The diagnostic specificity for Henoch-Schönlein purpura is improved if gastrointestinal involvement, upper respiratory infection, or age < 20 years is present. We propose diagnostic criteria for Henoch-Schönlein purpura incorporating clinical findings yielding sensitivity and specificity > 90%.