Doutre M S, Beylot C, Bioulac P, Conte M
Sem Hop. 1984 Apr 5;60(15):1040-2.
Although urticaria is usually held to be a type 1 hypersensitivity reaction, it may also be the cutaneous manifestation of vasculitis mediated by immune complexes. In this study of 35 patients with chronic urticaria, the authors attempted to specify the prevalence of vasculitis and its possible correlations with particular clinical and/or immunological findings. In 10 cases, lymphocyte subpopulations were also studied, using monoclonal antibodies. Patients included 21 women and 14 men, aged 19 to 80. In each patient: a) systemic signs were looked for by history taking and physical examination; b) a skin biopsy was examined by optic microscopy and direct immunofluorescence; c) the following biological investigations were done: blood count, sedimentation rate, protein electrophoresis and immunoelectrophoresis, IgE, B virus markers, circulating immune complexes, anti-nuclei and anti-ADN antibodies, latex and Waaler-Rose tests, total complement, C3, C4, and C1 esterase inhibitor. Visceral involvement and various immunological disorders are most common in those patients with leukoclastic (n = 7) or mononuclear (n = 9) vasculitis. These patients, as well as those recently studied in the literature, have idiopathic chronic urticaria, the least severe of urticarial vasculitis.
虽然荨麻疹通常被认为是一种Ⅰ型超敏反应,但它也可能是免疫复合物介导的血管炎的皮肤表现。在这项对35例慢性荨麻疹患者的研究中,作者试图明确血管炎的患病率及其与特定临床和/或免疫学发现的可能关联。在10例患者中,还使用单克隆抗体研究了淋巴细胞亚群。患者包括21名女性和14名男性,年龄在19至80岁之间。对每位患者:a)通过病史采集和体格检查寻找全身症状;b)对皮肤活检组织进行光学显微镜检查和直接免疫荧光检查;c)进行以下生物学检查:血细胞计数、血沉、蛋白电泳和免疫电泳、IgE、B病毒标志物、循环免疫复合物、抗核抗体和抗双链DNA抗体、乳胶试验和瓦氏反应、总补体、C3、C4和C1酯酶抑制剂。白细胞破碎性(n = 7)或单核细胞性(n = 9)血管炎患者中内脏受累和各种免疫紊乱最为常见。这些患者以及最近文献中研究的患者患有特发性慢性荨麻疹,这是荨麻疹性血管炎中最不严重的类型。