Clinicopathologic correlation of 282 leukocytoclastic vasculitis cases in a tertiary hospital: a focus on direct immunofluorescence findings at the blood vessel wall

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art_TAKATU_Clinicopathologic_correlation_of_282_leukocytoclastic_vasculitis_cases_in_2017.PDF (746.64 KB)
Citações na Scopus
12
Tipo de produção
article
Data de publicação
2017
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
HUMANA PRESS INC
Autores
CARVALHO, Jozelio Freire de
Citação
IMMUNOLOGIC RESEARCH, v.65, n.1, Special Issue, p.395-401, 2017
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
This is the largest direct immunofluorescence (DIF) analysis of patients with histology-proven cutaneous leukocytoclastic vasculitis (LCV). To establish the correlation of deposition of immune complexes at the blood vessel walls with underlying causes and prognosis of LCV, we performed a retrospective study from January 2007 to December 2014. The patients are followed at the Department of Dermatology, Hospital Das Clinicas da Faculdade de Medicina da Universidade de So Paulo, a tertiary hospital at So Paulo, Brazil. We reviewed the data of 282 biopsy-proven LCV cases with DIF performed. For the statistical analysis, we included only patients with positive DIF exclusively in vessel walls (235/282 patients). We planned to find a correlation between the DIF profiles of LCV patients and the epidemiology data, underlying causes and prognosis. Ages ranged from five to 87 years old (yo), median age of 45 and 191/282 (67.73 %) were female individuals. DIF analysis showed positivity in 70.21 % of the samples, and C3 was the most frequent immunoreactant. Immunoglobulin A (IgA) deposition at the blood vessel wall was related to age and absence of autoimmune/inflammatory diseases. Immunoglobulin M (IgM) deposition at the blood vessel wall was related to females, autoimmune/inflammatory disorders, C3 and C4 consumption and antinuclear antibody and anti-SSA/anti-SSB positivity. Immunoglobulin G (IgG) deposition at the blood vessel wall was associated with age and positive ANCA; finally, C3 deposition at the blood vessel wall was associated with hematuria and renal involvement. Systemic involvement was present in 12.5 % cases of LCV patients. C3 deposits, the most frequent finding of this study, were related to renal involvement; IgA deposits to absence of autoimmune or inflammatory diseases; IgM deposition to the presence of autoimmune or inflammatory diseases and IgG deposits were associated with positive ANCA. DIF seems to be an important method to establish the prognosis and underlying etiology of LCV. Characterization of the immune complex at the blood vessel wall by DIF is relevant to determine underlying conditions related to LCV.
Palavras-chave
Cutaneous vasculitis, Cutaneous leukocytoclastic vasculitis, Cutaneous small vessel vasculitis, Direct immunofluorescence
URI
https://observatorio.fm.usp.br/handle/OPI/20023
Referências
  1. Alalwani M, 2014, AM J DERMATOPATH, V36, P723, DOI 10.1097/DAD.0000000000000122
  2. Barnadas MA, 2004, INT J DERMATOL, V43, P19, DOI 10.1111/j.1365-4632.2004.01714.x
  3. Belli AA, 2014, EUR J DERMATOL, V24, P81, DOI 10.1684/ejd.2013.2243
  4. Borahay MA, 2009, AM J PERINAT, V26, P431, DOI 10.1055/s-0029-1214241
  5. Brons RH, 2001, ANN RHEUM DIS, V60, P1097, DOI 10.1136/ard.60.12.1097
  6. Carlson J, 2007, AM J DERMATOPATH, V29, P32, DOI 10.1097/01.dad.0000245198.80847.ff
  7. Fain O, 2007, ARTHRIT RHEUM-ARTHR, V57, P1473, DOI 10.1002/art.23085
  8. Garcia-Porrua C, 1998, ARTHRITIS RHEUM, V41, P1133, DOI 10.1002/1529-0131(199806)41:6<1133::AID-ART23>3.0.CO;2-S
  9. Gibson LE, 2001, DERMATOL CLIN, V19, P603, DOI 10.1016/S0733-8635(05)70303-X
  10. GOLDSTEIN AR, 1992, LANCET, V339, P280, DOI 10.1016/0140-6736(92)91341-5
  11. JOSEPH G, 1987, AM J OBSTET GYNECOL, V157, P911
  12. Koizumi M, 2004, J OBSTET GYNAECOL RE, V30, P37, DOI 10.1111/j.1341-8076.2004.00153.x
  13. Linskey KR, 2012, J AM ACAD DERMATOL, V66, P813, DOI 10.1016/j.jaad.2011.06.012
  14. Lotti T, 1998, J AM ACAD DERMATOL, V39, P667, DOI 10.1016/S0190-9622(98)70039-8
  15. MACKEL SE, 1982, ARCH DERMATOL, V118, P296, DOI 10.1001/archderm.118.5.296
  16. MERRILL J, 1994, BRIT J RHEUMATOL, V33, P586
  17. Minz RW, 2010, INDIAN J DERMATOL VE, V76, P150, DOI 10.4103/0378-6323.60561
  18. Oien RF, 2001, RHEUMATOLOGY, V40, P816, DOI 10.1093/rheumatology/40.7.816
  19. Pertuiset E, 2000, SEMIN ARTHRITIS RHEU, V29, P360, DOI 10.1053/sarh.2000.6988
  20. Podjasek JO, 2012, ACTA DERM-VENEREOL, V92, P388, DOI 10.2340/00015555-1288
  21. Russell JP, 2006, INT J DERMATOL, V45, P3, DOI 10.1111/j.1365-4632.2005.02898.x
  22. Sais G, 1998, ARCH DERMATOL, V134, P309, DOI 10.1001/archderm.134.3.309
  23. SANCHEZ NP, 1985, ARCH DERMATOL, V121, P220, DOI 10.1001/archderm.121.2.220
  24. SANCHEZGUERRERO J, 1990, J RHEUMATOL, V17, P1458
  25. SanchezPerez J, 1996, DERMATOLOGY, V193, P230
  26. Takeuchi S, 2010, J AM ACAD DERMATOL, V63, P1026, DOI 10.1016/j.jaad.2009.11.690
  27. Tomizawa K, 2003, BRIT J DERMATOL, V149, P439, DOI 10.1046/j.1365-2133.2003.05459.x
  28. TOSCA N, 1988, INT J DERMATOL, V27, P291, DOI 10.1111/j.1365-4362.1988.tb02353.x
  29. WESTEDT ML, 1984, J RHEUMATOL, V11, P448
  30. YASUE T, 1986, ARCH DERMATOL, V122, P66, DOI 10.1001/archderm.122.1.66
  31. Zurada JM, 2006, J AM ACAD DERMATOL, V55, pS65, DOI 10.1016/j.jaad.2005.10.011

Coleções
Artigos e Materiais de Revistas Científicas - FM/MDT
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/53
Artigos e Materiais de Revistas Científicas - LIM/56