Kato S, Ebina K, Naganuma H, Sato S, Maisawa S, Nakagawa H
Department of Paediatrics, Sendai City Hospital, Japan.
Eur J Pediatr. 1996 Feb;155(2):91-5. doi: 10.1007/BF02075757.
In patients with Henoch-Schönlein purpura (HSP) presenting with severe gastro-intestinal (GI) symptoms, IgA deposition was studied in endoscopically obtained mucosal biopsies. A total number of 11 patients (male, 7; female, 4) were enrolled in this study; 7 patients underwent upper GI endoscopy and biopsy 1 underwent sigmoidoscopy and 3 underwent both. Upper GI endoscopy in each patient showed various mucosal changes including redness, petechiae, erosions, and ulcerations, most predominant in the second part of the duodenum. Sigmoidoscopy demonstrated no abnormality in two of four patients. Intestinal deposition of IgA was positive in 7 of 11 patients with HSP. Histological examination showed non-specific inflammation of varying degrees in each patient, but no small vessel vasculitis was observed. IgA deposits were seen in only 2 of 23 control subjects with various GI diseases. Positive rate of IgA deposition per patient was significantly higher in patients with HSP than in controls (P < 0.005).
IgA deposition in the GI tract, as in the skin and kidneys, is characteristic of HSP. Intestinal IgA deposition complements the diagnostic criteria of HSP.
在患有严重胃肠道（GI）症状的过敏性紫癜（HSP）患者中，对内窥镜获取的黏膜活检组织中的IgA沉积进行了研究。本研究共纳入11例患者（男性7例，女性4例）；7例患者接受了上消化道内镜检查和活检，1例接受了乙状结肠镜检查，3例同时接受了两者检查。每位患者的上消化道内镜检查均显示出各种黏膜变化，包括发红、瘀点、糜烂和溃疡，最常见于十二指肠第二部。乙状结肠镜检查显示4例患者中有2例无异常。11例HSP患者中有7例IgA在肠道沉积呈阳性。组织学检查显示每位患者均有不同程度的非特异性炎症，但未观察到小血管血管炎。在23例患有各种胃肠道疾病的对照受试者中，只有2例观察到IgA沉积。HSP患者中每位患者的IgA沉积阳性率显著高于对照组（P < 0.005）。
与皮肤和肾脏一样，IgA在胃肠道的沉积是HSP的特征。肠道IgA沉积补充了HSP的诊断标准。
