ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

In the past year, the major contributions to our understanding of Churg-Strauss syndrome and polyarteritis nodosa were the development of classification criteria by which to separate these from other vasculitides. The absence of granulomas in most biopsies from patients with Churg-Strauss syndrome was noted. Other reports suggested that allergic disease may be only one of the hypereosinophilic conditions that predispose to this form of vasculitis. Eosinophilia and vasculitis occurring in a patient after dietary supplementation with L-tryptophan were reported, and the prominent cardiac involvement in Churg-Strauss syndrome was reemphasized. Impressive responses of that disease to cyclophosphamide were documented in one patient. In the American College of Rheumatology Vasculitis Classification Study, polyarteritis nodosa was one of the hardest vasculitides to distinguish. Several reports reiterated the serious risk of major pulmonary hemorrhage from microscopic polyarteritis of the lung, which probably represents aforme frusteof Wegener's granulomatosis. Although no new studies of therapy in polyarteritis were reported, a review of infections in such patients indicated that exposure to more than 15 mg/d of prednisone correlated with infectious complications, and that intra-abdominal infections were particularly problematic.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Wegner's granulomatosis is a clinicopathologic syndrome of unknown etiology characterized by granulomatous vasculitis of the upper and lower respiratory tracts and glomerulonephritis. During the period covered by this review several articles were published describing the clinical and pathologic features of Wegner's granulomatosis. Specifically, two large series are discussed reviewing the pulmonary manifestations of the disease and the histopathology of the head and neck disease associated with Wegner's granulomatosis. The majority of publications related to Wegner's granulomatosis concern anti-neutrophil cytoplasmic antibodies and their role in the diagnosis, management, and pathogenesis of Wegner's granulomatosis. In the period covered by this article, no new reports on the therapy of Wegner's granulomatosis were reviewed. However, two articles that address the efficiacy of cyclophosphamide pulse therapy in Wegner's granulomatosis have recently been published with conflicting conclusions. The data from these articles are mentioned but will be reviewed in more detail in a subsequent article.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Giant cell arteritis is a generalized vasculitis mainly affecting elderly people. The incidence is increasing, but only for women. The etiology is still unknown, but evidence suggests a cellular immunologic reaction against a local antigen present in the arterial wall. The disease can present itself with a great variety of symptoms. Constitutional symptoms such as fever, weight loss, and anorexia seem to be more common than hitherto believed. Onset of large artery involvement is independent of the evolution of the classic clinical symptoms. Peripheral synovitis is rarely seen in patients with polymyalgia rheumatica, and when it occurs, it is transient, nonerosive, and nondeforming. Glucocorticosteroids are the only generally accepted treatment in giant cell arteritis. After a higher initial dose of corticosteroids, most patients can be treated with a low maintenance dose, with little risk of steroid-induced osteoporosis. The erythrocyte sedimentation rate is still the best test for monitoring the disease.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Cutaneous vasculitis encompasses a highly heterogeneous group of disorders of diverse etiology, pathogenesis, and clinical features. Recent reexamination of clinical pathologic features have yielded no insights assisting our understanding of current clinical classification schemes and strengthening our clinical approach. Erythema nodosum is a common cutaneous disorder for which new etiologies continue to be described. Pyoderma gangrenosum is an uncommon ulcerative cutaneous condition that remains a therapeutic problem.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Few advances in our understanding of the polychondritic disease process have been made within the past year. Clinical studies have emphasized pulmonary manifestations and newer means of evaluation of functional and anatomic upper and lower airway disease. Esophageal dysfunction has been described. Further associations have been established with Sjögren's syndrome and with malignancy. Active disease during pregnancy was not associated with neonatal transmission. Although lacking diagnostic specificity, preliminary studies suggest that serum quantitation of a noncollagenous cartilage matrix protein may correlate with disease activity. Differential diagnosis must now include a recently described form of hereditary chondropathy. Segmental tracheal resection and splinting techniques including use of stents have been advocated for therapeutic management of severe tracheobronchial disease.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Angiitis signifies an inflammation of the blood vessels that can cause damage to vessel walls, vascular occlusion, and ischemic injury to organs served by these vessels, and it can occur in the central nervous system. All central nervous system vasculitides but one have been linked to the presence of various underlying disorders. This review covers primary and spinal cord granulomatous angiitis of the central nervous system, as well as secondary angiitis of the central nervous system and its associated underlying disorders.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Kawasaki disease is an acute vasculitis of infancy and early childhood. Left untreated, up to 25% of children with Kawasaki disease develop coronary artery abnormalities. Recent studies indicate that patients with Kawasaki disease have elevated cytokine production and increased expression of cytokine-inducible activation antigens on their vascular endothelium. Treatment with intravenous gammaglobulin significantly reduces the incidence of coronary artery abnormalities in this disease. Furthermore, patients who respond clinically to intravenous gammaglobulin demonstrate a marked reduction in immune activation. These recent insights into the immunology and treatment of Kawasaki disease may eventually provide new directions for research into the etiology of this fascinating disease.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Markers for systemic vasculitis may be useful in both assessment of disease activity and ascribing pathogenesis. Endo-thelial cell damage may be assessed by Factor VIII-related antigen and perhaps fibrinolysis (plasmin inhibitor/plasmin complex). Antibodies to endothelial cells potentially combine both assessment and pathogenesis. Complement fixing antibodies to endothelial cells, previously reported in systemic lupus erythematosus and Kawasaki syndrome, are also elevated in rheumatoid vasculitis. Their relationship to vascular endothelial cell antibodies, reported in a wide spectrum of systemic vasculitis, is not clear. A direct role for neutrophils in some forms of vasculitis is supported by the overlap of rheumatoid vasculitis with Sweet's syndrome, previously associated with both Behçet's and Crohn's syndrome. An indirect role of persistent neutrophil inflammation at mucosal surfaces is suggested by the vasculitis with antineutrophil cytoplasmic antibodies seen in cyctic fibrosis. In other cases, vasculitis may be triggered by direct viral infection such as cytomegalovirus. Experimental models may clarify the confusion. In the MRL mouse, vasculitis appears independent of the B-cell hyperacticity. Experimental models of uveitis also support a role for T cells in the induction of vasculitis.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID