Barbado Hernández F J, Gil Aguado A, San Martín P, Gutiérrez M, Guerra Vales J, Pamies Andreu F, Vázquez Rodríguez J J
Med Clin (Barc). 1979 Feb 25;72(4):149-53.
A case of panarteritis nodosa with positive Australia antigen is presented. Panarteritis appeared following serum hepatitis and caused arthromyalgia, abdominal pain, prolonged fever of unknown origin, peripheral polyneuropathy, blood hypertension, and renal insufficiency. A muscular biopsy showed atrophy due to denervation and necrotizing arteritis in various stages causing serious damage to the arteries. Abdominal arteriography clearly demonstrated the existence of aneurismal dilations in the liver, pancreas, and kidneys. The angiographic findings in panarteritis nodose are discussed with special reference to the aneurysms localized in several organs. Their situation is described in detail; it is usually abdominal and more specifically intrarenal. The fact that they occur in a high percentage of cases is helpful when establishing the diagnosis. Lastly, the role of Australia antigen in the development of panarteritis nodose is discussed. It stimulates an immune response and the production of circulating immunocomplexes which are depostied on the vascular walls with complement fixation and damage to the blood vessels. The possibility that other viral agents may be present in the various types of necrotizing vasculitis in humans is commented on.
本文报告一例澳大利亚抗原阳性的结节性多动脉炎病例。结节性多动脉炎在血清性肝炎后出现,导致关节痛、腹痛、不明原因的长期发热、周围性多神经病、高血压和肾功能不全。肌肉活检显示因去神经支配而萎缩,以及不同阶段的坏死性动脉炎,对动脉造成严重损害。腹部动脉造影清楚地显示肝脏、胰腺和肾脏存在动脉瘤样扩张。结合多个器官中出现的动脉瘤,对结节性多动脉炎的血管造影结果进行了讨论。详细描述了它们的情况;通常位于腹部,更具体地说是肾内。它们在高比例病例中出现这一事实有助于诊断的确立。最后,讨论了澳大利亚抗原在结节性多动脉炎发病中的作用。它刺激免疫反应并产生循环免疫复合物,这些复合物通过补体固定沉积在血管壁上,损害血管。文中还评论了人类各种类型坏死性血管炎中可能存在其他病毒病原体的可能性。