Nikolaishvili Mariam, Pazhava Ani, Di Lernia Vito
Faculty of Medicine, Ivane Javakhishvil Tbilisi State University, 0179 Tbilisi, Georgia.
American MD Program, Tbilisi State Medical University, 0186 Tbilisi, Georgia.
J Clin Med. 2023 Jan 16;12(2):697. doi: 10.3390/jcm12020697.
Henoch-Schönlein purpura or IgA vasculitis is the most common type of pediatric vasculitis that may affect adults as well. It is classified as a type of small-vessel vasculitis. It can cause cutaneous and systemic symptoms with a minority of patients developing kidney failure. Little is known about the specific pathophysiology of this disorder, except that it is believed to occur in individuals with abnormally glycosylated IgA1. Serum aberrant IgA1 may form large antigen-antibody complexes which, due to a defective clearance, are able to deposit in the small vessels of the skin, kidney, gut, and joints. A variety of factors, including infectious agents, drugs, and vaccines, have been identified as potential triggers. The majority of cases are preceded by upper respiratory tract infections, and seasonal variations suggest a link with many pathogens. The etiologic agent most frequently associated with IgA vasculitis historically have been group A β-hemolytic streptococcus and common respiratory tract viruses. However, during the current coronavirus pandemic, SARS-CoV-2 infection was identified as a main trigger factor. In addition, IgA vasculitis has been observed following COVID-19 immunization. This review provides insights into the state of the art on the relationship between viral infections, viral vaccines, and Henoch-Schönlein purpura.
过敏性紫癜或IgA血管炎是最常见的小儿血管炎类型，也可能影响成人。它被归类为一种小血管血管炎。它可引起皮肤和全身症状，少数患者会发展为肾衰竭。除了认为它发生在异常糖基化IgA1的个体中之外，人们对这种疾病的具体病理生理学知之甚少。血清异常IgA1可能形成大的抗原-抗体复合物，由于清除缺陷，这些复合物能够沉积在皮肤、肾脏、肠道和关节的小血管中。多种因素，包括感染因子、药物和疫苗，已被确定为潜在的触发因素。大多数病例在呼吸道感染之前出现，季节性变化表明与许多病原体有关。历史上与IgA血管炎最常相关的病原体是A组β溶血性链球菌和常见呼吸道病毒。然而，在当前的冠状病毒大流行期间，SARS-CoV-2感染被确定为主要触发因素。此外，在COVID-19免疫接种后也观察到了IgA血管炎。本综述提供了关于病毒感染、病毒疫苗与过敏性紫癜之间关系的最新见解。
