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结节性多动脉炎型血管炎与人类免疫缺陷病毒感染

[Periarteritis nodosa-type vasculitis and infection with human immunodeficiency virus].

作者信息

Conri C, Mestre C, Constans J, Vital C

机构信息

Service de Médecine Interne, Hôpital Haut Levêque, Pessac.

出版信息

Rev Med Interne. 1991 Jan-Feb;12(1):47-51. doi: 10.1016/s0248-8663(05)81353-0.

Abstract

The human immunodeficiency virus (HIV) may be responsible for several types of vasculitis: leucocytoclastic vasculitis, granulomatous angiitis, angiitis associated with lymphoproliferative syndromes or necrotizing vasculitis including periarteritis nodosa (PAN). We report a case of PAN in a 62-year old HIV1-positive woman. The patient had no co-occurrent hepatitis B virus infection and was negative for antinuclear antibodies. She presented with sicca syndrome, necrotic purpura, myalgias and polyneuropathy. Skin, muscle and nerve biopsies showed signs of necrotizing vasculitis. Multiple microaneurysms typical of PAN were present on branches of the abdominal aorta. The symptoms due to vasculitis regressed after treatment with corticosteroids in bolus injections and plasmapheresis. AZT was not given owing to intolerance. The literature on vasculitis associated with HIV infection is reviewed.

摘要

人类免疫缺陷病毒(HIV)可能是几种血管炎的病因:白细胞破碎性血管炎、肉芽肿性血管炎、与淋巴增殖综合征相关的血管炎或坏死性血管炎,包括结节性多动脉炎(PAN)。我们报告一例62岁HIV-1阳性女性患结节性多动脉炎的病例。该患者无同时感染乙型肝炎病毒,抗核抗体阴性。她表现为干燥综合征、坏死性紫癜、肌痛和多发性神经病。皮肤、肌肉和神经活检显示有坏死性血管炎的迹象。腹主动脉分支上出现了典型的PAN多发性微动脉瘤。大剂量注射皮质类固醇和血浆置换治疗后,血管炎引起的症状消退。由于不耐受未给予齐多夫定(AZT)。本文对与HIV感染相关的血管炎文献进行了综述。

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