Hafner O, Witte T, Schmidt R E, Vakilzadeh F
Hautklinik, Städtischen Krankenhauses Hildesheim.
Hautarzt. 1994 May;45(5):339-43. doi: 10.1007/s001050050080.
Necrobiotic xanthogranuloma is a non-X histiocytosis with unknown pathogenesis. It is associated with paraproteinaemia, and in rare cases with multiple myeloma. A decreased level of C1 inhibitor has been found in several cases without clinical manifestations of Quincke oedema. We report on a patient with necrobiotic xanthogranuloma and myeloma, in whom we found a decreased level of C1 inhibitor and recurrent episodes of manifest Quincke oedema. The indirect detection of auto-antibodies against the paraprotein with development of immune complexes is regarded as an explanation for the consumption of the C1 inactivator and the manifestation of Quincke oedema. The possibility of a causal relationship between paraproteinaemia and necrotic xanthogranuloma is discussed.
坏死性黄色肉芽肿是一种发病机制不明的非X组织细胞增多症。它与副蛋白血症相关,在罕见情况下与多发性骨髓瘤有关。在几例无昆克水肿临床表现的病例中发现C1抑制剂水平降低。我们报告了一例患有坏死性黄色肉芽肿和骨髓瘤的患者,我们在该患者中发现C1抑制剂水平降低以及明显的昆克水肿反复发作。针对副蛋白产生免疫复合物的自身抗体间接检测被认为是C1灭活剂消耗和昆克水肿表现的一种解释。文中讨论了副蛋白血症与坏死性黄色肉芽肿之间存在因果关系的可能性。