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[感染与血管炎]

[Infections and vasculitis].

作者信息

Glück T, Straub R H, Schölmerich J, Lang B

机构信息

Klinik und Poliklinik für Innere Medizin I Klinikum der Universität Regensburg, Regensburg.

出版信息

Z Rheumatol. 1997 May-Jun;56(3):105-13. doi: 10.1007/s003930050026.

Abstract

Vasculitides are rare diseases characterized by inflammation of blood vessels. According to diameter of the blood vessels involved in the inflammatory process, the clinical presentation and the histological appearance, different vasculitic syndromes may be distinguished. Primary vasculitides are of unknown origin while secondary vasculitides may be caused by drugs, malignancy or infection. Panarteriitis nodosa caused by chronic Hepatitis B and mixed cryoglobulinemia secondary to chronic Hepatitis C are classical examples of vasculitides triggered by infections. However, these are rare complications of chronic viral hepatitis. Patients infected by HIV frequently suffer from vasculitis, which may be caused by opportunistic infections and by defects in immune regulation. In numerous case reports, various other infectious particles have been reported to cause different forms of vasculitis, either by direct infection of endothelial cells or by induction of an immunologic process leading to blood vessel destruction. Immunologically mediated vasculitis secondary to infection may be due to a predisposing reactivity of the patient's immune system. After successful treatment of the infection, the vasculitis usually subsides. Therefore, all patients with vasculitis should be evaluated for underlying infection.

摘要

血管炎是一类以血管炎症为特征的罕见疾病。根据炎症过程中受累血管的直径、临床表现和组织学表现,可以区分不同的血管炎综合征。原发性血管炎病因不明,而继发性血管炎可能由药物、恶性肿瘤或感染引起。由慢性乙型肝炎引起的结节性多动脉炎和慢性丙型肝炎继发的混合性冷球蛋白血症是感染引发血管炎的典型例子。然而,这些都是慢性病毒性肝炎的罕见并发症。感染HIV的患者经常患有血管炎,这可能是由机会性感染和免疫调节缺陷引起的。在众多病例报告中,据报道各种其他感染因子可通过直接感染内皮细胞或通过诱导导致血管破坏的免疫过程而引起不同形式的血管炎。感染继发的免疫介导性血管炎可能归因于患者免疫系统的易感性反应。感染成功治疗后,血管炎通常会消退。因此,所有血管炎患者都应评估是否存在潜在感染。

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