ISSN:1040-8711    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Usually classifications of vasculitic syndromes are based on clinical and histopathologic findings because pathogenetic mechanisms are poorly understood. A subcommittee of the Diagnostic and Therapeutic Criteria Committee of the American College of Rheumatology recently developed classification criteria for seven major vasculitic disorders through the analysis of prospectively collected patient data from 48 centers. Using two classification methods, the subcommittee derived criteria for polyarteritis nodosa, Churg-Strauss syndrome, Wegener's granulomatosis, hypersensitivity vasculitis, Henoch-Schbnlein purpura, giant cell (temporal) arteritis, and Takayasu's arteritis. Although such criteria may identify typical patients with a distinct form of vasculitis, they are not intended to establish a diagnosis in an individual patient; rather, they should aid comparability of different patient groups in various research endeavors.

ISSN:1040-8711    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Antineutrophil cytoplasmic autoantibodies are a useful diagnostic serologic marker for a variety of well-known vasculitic syndromes, including Wegener's granulomatosis, polyarteritis nodosa (especially microscopic polyarteritis nodosa), Churg-Strauss syndrome, and pulmonary-renal syndrome with alveolar capillaritis. Although most patients with antineutrophil cytoplasmic autoantibody-associated disease have systemic disease, disease limited to one organ does occur,eg, isolated necrotizing glomerulonephritis, isolated respiratory tract disease, or isolated orbital disease. Antineutrophil cytoplasmic autoantibody titers may be useful in modulating treatment regimens. There isin vitroevidence that antineutrophil cytoplasmic autoantibodies are directly involved in the pathogenesis of antineutrophil cytoplasmic autoantibody-associated vasculitides.

ISSN:1040-8711    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Wegener's granulomatosis is a clinicopathologic syndrome of unknown etiology characterized by granulomatous vasculitis of the upper and lower respiratory tracts and by glomerulonephritis. Virtually any organ system can be affected, and many patients present with unusual features of disease. During the period covered by this review, several articles reported atypical manifestations of Wegener's granulomatosis, including diffuse pulmonary infiltrates, lymphadenopathy, diffuse pulmonary hemorrhage, and overlap with giant cell arteritis. Unusual features of upper airway, eye, gastrointestinal, nervous system, and genitourinary tract disease were also described, and less common histopathologic features of pulmonary and nasal disease were characterized.

ISSN:1040-8711    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Giant cell arteritis is a generalized inflammatory disorder involving large and medium-sized arteries. The etiology is unknown, although an autoimmune pathogenesis seems probable. In view of the clinical similarities between patients with positive biopsy findings for polymyalgia rheumatica and those with negative biopsy findings, many authors favor the concept that polymyalgia rheumatica is an expression of an underlying giant cell arteritis. There is, however, still controversy as to whether polymyalgia rheumatica and temporal arteritis are different expressions of one and the same disease or two separate, partly overlapping types of giant cell arteritis. A single etiologic factor may be responsible for the two conditions, sometimes expressing itself as polymyalgia rheumatica and sometimes as giant cell arteritis. Recent findings of morphologic similarities in terms of arterial wall atrophy, calcifications, and inflammatory reactions may indicate that polymyalgia rheumatica and temporal arteritis represent different degrees or stages of the same disease.

ISSN:1040-8711    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Behçet's disease is a systemic inflammatory disorder capable of inducing thrombophlebitis. Clinicopathologically, it is characterized by neutrophil and platelet hyperfunction. Lesions are formed presumably because neutrophils infiltrating the affected tissue release active oxygen and lysosomal enzymes in large amounts. The mechanism of neutrophil hyperfunction was obscure, but in recent years attention has focused on the effects of cytokines released by mononuclear cells. As more has been learned about the etiopathogenesis of Behçet's disease, novel anti-inflammatory drugs, immunosuppressants, antithrombotic agents, and anticoagulants have helped to achieve remarkable progress in treatment. Particularly notable is the effect on severe uveitis of cyclosporine, which is more effective than colchicine and conventional immunosuppressants. With the advent of cyclosporine, the number of patients with Behçet's disease who lose their eyesight has clearly decreased.

ISSN:1040-8711    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

An infectious cause has long been suspected for most forms of vasculitis. In most cases vascular damage has been ascribed to immune-mediated mechanisms rather than direct microbial toxicity. Evidence cited in this review provides further support for a causal role of infection in the vasculitides by strengthening the link between group A streptococci and hepatitis B virus with polyarteritis nodosa and Kawasaki syndrome. It is anticipated that the application of new molecular technology will provide definitive evidence for the role of infection in the etiopathogenesis of the vasculitides.

ISSN:1040-8711    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

A large variety of vasculopathic syndromes are uncommonly associated with malignancies. Vasculitis is usually manifested by skin lesions and is generally associated with hematologic malignancies rather than solid tumors. Evidence of autoantibodies, immune complexes, and complement consumption is typically absent. Myelodysplastic syndromes can be confidently linked to vasculitis on the basis of recent literature. The temporal relationship of malignancy to vasculitis development is variable except that vasculitis generally follows the discovery of hairy cell leukemia and splenectomy. Vasculitis may occasionally be a complication of chemotherapy, radiation therapy, and bone marrow transplantation. Occasionally, malignant disorders may mimic vasculitic syndromes. The etiopathogenesis of vasculitis in patients with malignant disorders is unknown. The recent literature on vasculitis and malignancy addresses predominantly case reports and small patient cohorts and identifies clinical characteristics rather than pathogenic mechanisms.

ISSN:1040-8711    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

A variety of common and uncommon nonvasculitic disorders may mimic vasculitis clinically, angiographically, or even histologically. These are the vasculitis simulators and vasculitis look-alikes. It is important to distinguish these vasculitis simulators from true vasculitis in order to avoid the unnecessary and harmful side effects of corticosteroids and cytotoxic agents, the mainstay of drug therapy for vasculitis.

ISSN:1040-8711    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

I shall propose nothing merely dictated from theory; but shall confirm all by experiencing and facts, the surest and most unerring guides.

ISSN:1040-8711    

出版商:OVID    

年代:1992

数据来源: OVID