de Groot K, Schnabel A, Gross W L
Poliklinik für Rheumatologie der Med. Universität Lübeck.
Z Rheumatol. 1995 Sep-Oct;54(5):291-302.
The ANCA-associated vasculitides (Wegener's granulomatosis, Churg-Strauss syndrome, microscopic polyangiitis) are characterized by a broad spectrum of clinical manifestations and a highly variable clinical course. Due to greatly improved diagnostic techniques the number of newly diagnosed cases has increased rapidly within the past few years. This facilitated more individualized treatment and led to the concept of stage-adapted treatment. Immunodiagnostic parameters are being utilized increasingly to supplement clinical and radiological findings. Inflammatory lesions are visualized by, for example, e.g. rhinoscopy, sinoscopy, and bronchoscopy or by radiological techniques including cranial and skeletal muscle magnetic resonance imaging, pulmonary high-resolution computed tomography, and digital subtraction angiography. These techniques not only serve to detect the extent of tissue and organ involvement, but also to direct bioptic procedures. Conventional histopathology must be supplemented by immunohistology in order to distinguish between the "immune complex vasculitides" and the ANCA-associated "pauci-immune vasculitides".
抗中性粒细胞胞浆抗体相关性血管炎(韦格纳肉芽肿、变应性肉芽肿性血管炎、显微镜下多血管炎)具有广泛的临床表现谱和高度可变的临床病程。由于诊断技术的极大改进,过去几年新诊断病例数迅速增加。这有助于更个体化的治疗,并催生了分期适应性治疗的概念。免疫诊断参数越来越多地用于补充临床和影像学检查结果。炎症性病变可通过例如鼻镜检查、鼻窦镜检查和支气管镜检查,或通过包括头颅和骨骼肌磁共振成像、肺部高分辨率计算机断层扫描和数字减影血管造影在内的放射学技术显示。这些技术不仅用于检测组织和器官受累的程度,还用于指导活检程序。传统组织病理学必须辅以免疫组织学,以区分“免疫复合物性血管炎”和抗中性粒细胞胞浆抗体相关性“寡免疫性血管炎”。