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[从自身免疫性疾病角度看慢性荨麻疹]

[Chronic urticaria from the aspect of autoimmune diseases].

作者信息

Jovanović M, Lenert P, Poljacki M, Mitić I, Duran V

机构信息

Klinika za infektivne i dermatoveneroloske bolesti, Medicinski fakultet, Novi Sad.

出版信息

Med Pregl. 1995;48(5-6):183-6.

PMID:7565341
Abstract

At some time in their lives one in a five persons is affected by urticaria and/or angioedema. The cause of urticaria may never be found in up to one quarter of patients with acute urticaria and in up to 90-95% with chronic urticaria. In this study we present results of our compounded approach (clinical follow up, laboratory findings, allergological testing) to patients with chronic urticaria and autoimmune diseases that progressed into chronic urticaria or started before the onset of the chronic urticaria. Our first case was a 56 year old woman with a 10 month history of chronic urticaria, angioedema and chronic gastritis before the diagnoses of insulin dependent Diabetes mellitus and Hypothyreoidismus primarius were established. Allergological testing reveals specific clinical significant immediate reaction to Balsam Peru. After adequate substitutional therapy was advocated and with specific clinical avoidance of offended allergen, remission was obtained. The second case was a 46 year old female suffering from chronic urticaria (with clinical features of urticaria like vasculitis) associated with hypocomplementemia (particularly C4 depressed) with negative antinuclear antibodies but positive circulating immune complexes after a 2 year follow up the patient developed Systemic lupus erythematosus. The third case was a 63 year old woman who developed chronic urticaria 3 years after total thyroidectomy, with pathological finding of Thyroiditis lymphocytaria-Hashimoto; after the allergological testing, positive lymphocyte transformation test revealed allergical sensitization to Vobenol was substituted with Thyvoral, complete remission was obtained.

摘要

在人生的某个阶段,五分之一的人会受到荨麻疹和/或血管性水肿的影响。在高达四分之一的急性荨麻疹患者以及高达90 - 95%的慢性荨麻疹患者中,荨麻疹的病因可能永远无法找到。在本研究中,我们展示了针对慢性荨麻疹患者以及已发展为慢性荨麻疹或在慢性荨麻疹发作之前就已存在的自身免疫性疾病患者所采用的综合方法(临床随访、实验室检查结果、变应性检测)的结果。我们的第一个病例是一名56岁女性,在确诊胰岛素依赖型糖尿病和原发性甲状腺功能减退症之前,有10个月的慢性荨麻疹、血管性水肿和慢性胃炎病史。变应性检测显示对秘鲁香脂有特定的临床显著即刻反应。在提倡进行适当的替代治疗并在临床上特别避免接触致敏变应原后,病情得到缓解。第二个病例是一名46岁女性,患有慢性荨麻疹(具有荨麻疹样血管炎的临床特征),伴有补体减少(尤其是C4降低),抗核抗体阴性,但循环免疫复合物阳性。经过2年随访,该患者发展为系统性红斑狼疮。第三个病例是一名63岁女性,在全甲状腺切除术后3年出现慢性荨麻疹,病理检查发现淋巴细胞性甲状腺炎——桥本氏病;变应性检测后,阳性淋巴细胞转化试验显示对Vobenol过敏致敏,用Thyvoral替代后,病情完全缓解。

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