Wattiaux M J, Kahn M F, Bourgeois P, Vinceneux P, Grossin M, Kaplan G
Rev Rhum Mal Osteoartic. 1985 Nov;52(11):599-603.
Diffuse inflammatory angiitis is seen in extremely varied aetiological and nosological situations. In some cases, the vascular disease represents the only sign of systemic disease. In other cases, it mays be associated with or complicated by diffuse systemic inflammatory conditions. This study analysed 100 cases of inflammatory angiitis with systemic manifestations seen over a period of 7 years in a rheumatology department. Patients with scleroderma, erythema nodosa, Behçet's syndrome and angiitis associated with microbial infectious diseases were excluded from this study. 24 cases in which the angiitis was clinically certain, but in which the vascular lesion was not confirmed histologically were also excluded. The type of histological lesion and the nosological distribution of these 100 cases are described in detail. The results of this analysis confirm the very great variety of the clinical and histological presentations. A number of rare syndromes were observed. Classical periarteritis nodosa only represented 14 per cent of the whole series and only 3 of the 14 cases had a demonstrable aetiology (2 HBs, 1: desensitisation to Candidin). The authors stress the histological diversity of inflammatory angiitis associated with rheumatoid arthritis and systemic lupus erythematosus. All sizes of vessels may be involved and all types of lesions can be observed in these two diseases. The authors also emphasise the lesser known clinical and histological features (stenosing endarteritis of the great vessels in systemic lupus erythematosus) and previously unreported cases (valvular lesions in 2 cases of Mac Duffie's syndrome, progression of 2 cases of delayed urticaria to pressure towards a clinical lupus with unusual laboratory findings).(ABSTRACT TRUNCATED AT 250 WORDS)
弥漫性炎性血管炎可见于极为多样的病因学和疾病分类学情况。在某些病例中,血管疾病是全身性疾病的唯一表现。在其他病例中,它可能与弥漫性全身性炎性疾病相关或并发。本研究分析了风湿病科7年间所见的100例有全身表现的炎性血管炎病例。硬皮病、结节性红斑、白塞综合征以及与微生物感染性疾病相关的血管炎患者被排除在本研究之外。24例临床确诊为血管炎但组织学上未证实有血管病变的病例也被排除。详细描述了这100例病例的组织学病变类型和疾病分类分布情况。该分析结果证实了临床和组织学表现的多样性。观察到了一些罕见综合征。经典结节性多动脉炎仅占整个系列的14%,14例病例中只有3例有可证实的病因(2例乙肝,1例:对念珠菌素脱敏)。作者强调了与类风湿关节炎和系统性红斑狼疮相关的炎性血管炎的组织学多样性。在这两种疾病中,各种大小的血管都可能受累,且可观察到所有类型的病变。作者还强调了鲜为人知的临床和组织学特征(系统性红斑狼疮中大动脉的狭窄性动脉内膜炎)以及此前未报告的病例(2例麦克达菲综合征中有瓣膜病变,2例迟发性荨麻疹进展为向有异常实验室检查结果的临床狼疮转变)。(摘要截选于250词)