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[白细胞破碎性血管炎]

[Leukocytoclastic vasculitis].

作者信息

Sunderkötter C, Roth J, Bonsmann G

机构信息

Universitätsklinik und Poliklinik für Dermatologie und Allergologie, Universitätsklinikum Ulm, Ulm.

出版信息

Hautarzt. 2004 Aug;55(8):759-83; quiz 784-5. doi: 10.1007/s00105-004-0760-1.

Abstract

Leukocytoclastic vasculitis (LcV) is the most common form of cutaneous vasculitis. Often LcV results from deposition of immune complexes in the vascular wall. When IgA is the dominant immunoglobulin in these complexes, systemic involvement is likely (Henoch-Schönlein purpura), being more severe in adults. LcV in which immune complexes are composed of IgG or IgM are more often limited to the skin and may additionally show minor systemic involvement. In other forms of LcV additional pathophysiological factors play a role. LcV can also be a presenting or accompanying symptom of severe systemic ANCA-associated vasculitis. In some cases, LcV is a sign of bacteriemia. The aim of diagnostic procedures is to determine the specific type of vasculitis and degree of systemic involvement as well as possible causes. If no trigger or cause can be found, uncomplicated cases of LcV should be treated symptomatically. Corticosteroids are indicated at initial signs of necrosis or ulceration. Chronic recurrent LcV may respond to dapsone or colchicine. Severe systemic vasculitis requires immunosuppressive therapy.

摘要

白细胞破碎性血管炎(LcV)是皮肤血管炎最常见的形式。LcV通常是由免疫复合物在血管壁沉积所致。当IgA是这些复合物中的主要免疫球蛋白时,可能会出现全身受累(过敏性紫癜),在成人中更为严重。由IgG或IgM组成免疫复合物的LcV更常局限于皮肤,可能还会有轻微的全身受累表现。在其他形式的LcV中,其他病理生理因素也起作用。LcV也可能是严重的系统性抗中性粒细胞胞浆抗体相关性血管炎的首发或伴随症状。在某些情况下,LcV是菌血症的体征。诊断程序的目的是确定血管炎的具体类型、全身受累程度以及可能的病因。如果找不到触发因素或病因,无并发症的LcV病例应进行对症治疗。在出现坏死或溃疡的初始迹象时,应使用皮质类固醇。慢性复发性LcV可能对氨苯砜或秋水仙碱有反应。严重的系统性血管炎需要免疫抑制治疗。

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