PATHOGENESIS OF ARTHRITIS ASSOCIATED WITH VIRAL HEPATITIS - COMPLEMENT-COMPONENT STUDIES
PATHOGENESIS OF ARTHRITIS ASSOCIATED WITH VIRAL HEPATITIS - COMPLEMENT-COMPONENT STUDIES
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DOI：
10.1056/nejm197107222850401
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发表时间：
1971-01-01
影响因子：
158.5
通讯作者：
SCHUR, PH
中科院分区：
文献类型：
--
作者：
ALPERT, E;ISSELBAC.KJ;SCHUR, PH
18例急性病毒性肝炎患者的初始症状为关节痛、关节炎或荨麻疹。血清总溶血性补体（CH 50）和C4往往是严重抑郁症的9例患者在急性期的联合症状。C3水平中度降低，C1q水平变化很大。C1抑制物和C9血清浓度正常。病毒性肝炎患者在恢复期或关节炎缓解期，或没有这些症状的历史，有正常或升高的血清CH 50和C3水平，一个广泛的变化C1q水平和低正常C4水平。病毒性肝炎患者血清补体水平低与肝炎相关抗原滴度高有关。5例急性非病毒性肝炎患者血清补体水平正常或升高。关节和皮肤症状与肝炎相关抗原的相关性以及急性状态下补体活性的降低水平表明，这种血清病样综合征可能由循环免疫复合物引起。
Eighteen patients with acute viral hepatitis had initial symptoms of arthralgia, arthritis or urticaria. Total serum hemolytic complement (CH50) and C4 tended to be severely depressed in the nine patients studied in the acute phase of their joint symptoms. The C3 levels were moderately depressed, and the C1q levels were widely variable. C1 inhibitor and C9 serum concentrations were normal. Patients with viral hepatitis in convalescence or remission from arthritis, or without a history of these symptoms, had a normal or elevated serum CH50and C3 level, a widely variable C1q level and low normal C4 levels. Low serum levels of complement in viral hepatitis were associated with high titers of hepatitis-associated antigen. Five patients with acute nonviral hepatitis had normal or elevated serum complement levels. The correlation of joint and skin symptoms with hepatitis-associated antigen and depressed levels of complement activity in the acute state suggests that this serum-sickness-like syndrome may be caused by circulating immune complexes.