Sarkar Namrata, Palit Aparna, Sethy Madhusmita, Behera Biswanath, Dash Siddhartha, Sahu Dinesh P
Dermatology and Venereology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND.
Dermatology and Venereology, All India Institute of Medical Sciences, Kalyani, Kalyani, IND.
Cureus. 2022 May 9;14(5):e24845. doi: 10.7759/cureus.24845. eCollection 2022 May.
Introduction The role of serum C3 and C4 levels as a marker of disease activity in cutaneous small-vessel vasculitis (CSVV) has been sparsely studied, especially in India. The primary objective was to determine the correlation between clinico-histopathological severity and serum C3 and C4 levels in CSVV. The secondary objective was to determine the association between direct immunofluorescence (DIF) findings and serum C3 and C4 levels and clinico-histopathological findings. Method This prospective cross-sectional study included all the clinically diagnosed cases of CSVV that satisfied the pathological criteria for CSVV. A clinical disease activity grade and a histopathological severity grade were calculated in all patients (N=50). Results Serum C3 and C4 levels (n=44) were diminished in 4.5% of cases. There was no significant correlation between the serum C3 and C4 levels and the clinical and histopathological severity. DIF was positive in 60.0% of cases (n=45), and IgA was the predominant immune deposit (46.7%). No significant association was detected between the DIF findings and the serum C3 and C4 levels, histopathological severity, and clinical disease activity grade. Positive DIF findings were significantly associated with palpable purpura and cutaneous necrosis. A significant association was detected between gastrointestinal involvement and IgA positivity. Conclusion In CSVV, serum C3 and C4 may not be used as markers of disease severity, and a positive DIF finding may indicate an underlying gastrointestinal involvement.
引言 血清C3和C4水平作为皮肤小血管炎（CSVV）疾病活动标志物的作用研究较少，尤其是在印度。主要目的是确定CSVV临床组织病理学严重程度与血清C3和C4水平之间的相关性。次要目的是确定直接免疫荧光（DIF）结果与血清C3和C4水平以及临床组织病理学结果之间的关联。方法 这项前瞻性横断面研究纳入了所有临床诊断为CSVV且符合CSVV病理标准的病例。计算了所有患者（N = 50）的临床疾病活动分级和组织病理学严重程度分级。结果 4.5%的病例血清C3和C4水平（n = 44）降低。血清C3和C4水平与临床和组织病理学严重程度之间无显著相关性。60.0%的病例（n = 45）DIF呈阳性，IgA是主要的免疫沉积物（46.7%）。DIF结果与血清C3和C4水平、组织病理学严重程度及临床疾病活动分级之间未检测到显著关联。DIF阳性结果与可触及性紫癜和皮肤坏死显著相关。检测到胃肠道受累与IgA阳性之间存在显著关联。结论 在CSVV中，血清C3和C4可能不能用作疾病严重程度的标志物，DIF阳性结果可能表明潜在的胃肠道受累。
