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过敏性紫癜及其他血管炎疾病患儿的免疫球蛋白和补体研究

Immunoglobulin and complement studies in children with Schönlein-Henoch Syndrome and other vasculitic diseases.

作者信息

Petersen S, Taaning E, Söderström T, Pilgaard B, Tranebjaerg L, Christensen T, Nielsen H E

机构信息

Department of Paediatrics, Glostrup Hospital, Denmark.

出版信息

Acta Paediatr Scand. 1991 Nov;80(11):1037-43. doi: 10.1111/j.1651-2227.1991.tb11780.x.

Abstract

In 35 children with Schönlein-Henoch Syndrome (SHS) serum IgG, IgM, and IgA concentrations were increased in 15%, 21%, and 44% of cases, respectively. Seven children with other vasculitic syndromes (VS) had normal serum Ig concentrations. Serum concentration of IgG subclass IgG1 was increased in 72% of children with SHS and 57% with VS. In SHS this was related to the presence of arthritis, but inversely related to nephritic symptoms. Only a few children had IgG subclasses IgG2, IgG3, or IgG4 concentrations outside the normal ranges. Platelet associated Ig (PAIg) was found in 75% of children with SHS or VS. In SHS the identification of increased amounts of PAIgG was related to the presence of nephritis. The serum concentration of properdin, a component of the alternative complement system, was reduced in 21% of children with SHS. This was related to the presence of abdominal symptoms or nephritis. No cases of retinal vasculitis was observed, but 4 of 22 children with SHS had punctuate retinal haemorrhages. SHS and VS may be clinical variations of the same syndrome. The immunological aspects indicate a close relationship with autoimmune diseases.

摘要

在35例过敏性紫癜患儿中,血清IgG、IgM和IgA浓度升高的病例分别占15%、21%和44%。7例患有其他血管炎综合征(VS)的患儿血清免疫球蛋白浓度正常。过敏性紫癜患儿中72%以及血管炎综合征患儿中57%的血清IgG亚类IgG1浓度升高。在过敏性紫癜中,这与关节炎的存在有关,但与肾病症状呈负相关。只有少数患儿的IgG亚类IgG2、IgG3或IgG4浓度超出正常范围。75%的过敏性紫癜或血管炎综合征患儿存在血小板相关免疫球蛋白(PAIg)。在过敏性紫癜中,PAIgG含量增加与肾炎的存在有关。21%的过敏性紫癜患儿替代补体系统成分备解素的血清浓度降低。这与腹部症状或肾炎的存在有关。未观察到视网膜血管炎病例,但22例过敏性紫癜患儿中有4例出现点状视网膜出血。过敏性紫癜和血管炎综合征可能是同一综合征的临床变异。免疫学方面表明与自身免疫性疾病密切相关。

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