Burden A D, Tillman D M, Foley P, Holme E
Department of Dermatology, Western Infirmary, Glasgow, Scotland, UK.
J Am Acad Dermatol. 1996 Sep;35(3 Pt 1):411-5. doi: 10.1016/s0190-9622(96)90606-4.
Autoantibodies may be detected in the serum of some patients with cutaneous leukocytoclastic vasculitis. We have previously reported the presence of IgA anticardiolipin antibodies (ACAs) in one patient with leukocytoclastic vasculitis associated with IgA nephropathy.
Our purpose was to determine the prevalence of IgA ACAs in unselected groups of patients with cutaneous vasculitis, IgA nephropathy, and Henoch-Schönlein purpura.
Thirty patients (10 each with cutaneous vasculitis, IgA nephropathy, and Henoch-Schönlein purpura) and 31 healthy control subjects were studied. ACA titers were measured by a standardized enzyme-linked immunosorbent assay.
ACAs restricted to the IgA isotype were present in 6 of 10 patients with cutaneous leukocytoclastic vasculitis. IgA ACA levels were significantly higher in these patients than in the control subjects. The presence of IgA ACAs did not correlate with disease severity or involvement of other organs and persisted after resolution of the vasculitis in most patients. In five of the six patients with IgA ACAs, drugs were implicated in the pathogenesis of the vasculitis. By contrast, ACAs were present in only a minority of children with Henoch-Schönlein purpura and adults with IgA nephropathy and were not restricted to the IgA isotype.
We have demonstrated a clear association between IgA ACAs and cutaneous leukocytoclastic vasculitis. The absence of IgA ACAs in Henoch-Schönlein purpura argues against their being an epiphenomenon in vasculitis.
在一些皮肤白细胞破碎性血管炎患者的血清中可检测到自身抗体。我们之前报道过1例合并IgA肾病的白细胞破碎性血管炎患者存在IgA抗心磷脂抗体（ACA）。
我们的目的是确定在未经过挑选的皮肤血管炎、IgA肾病和过敏性紫癜患者群体中IgA ACA的患病率。
研究了30例患者（皮肤血管炎、IgA肾病和过敏性紫癜各10例）以及31名健康对照者。通过标准化酶联免疫吸附试验检测ACA滴度。
10例皮肤白细胞破碎性血管炎患者中有6例存在仅限于IgA同种型的ACA。这些患者的IgA ACA水平显著高于对照者。IgA ACA的存在与疾病严重程度或其他器官受累无关，且在大多数患者血管炎消退后仍持续存在。在6例有IgA ACA的患者中，有5例血管炎的发病机制与药物有关。相比之下，仅少数过敏性紫癜儿童和IgA肾病成人存在ACA，且不限于IgA同种型。
我们已证实IgA ACA与皮肤白细胞破碎性血管炎之间存在明确关联。过敏性紫癜中不存在IgA ACA，这表明它们并非血管炎中的一种附带现象。
