RESUMEN
The extent to which the immunofluorescent phenomenon of homogeneous deposition of IgA in the hepatic sinusoids (so-called continuous pattern) was specific for alcoholic hepatic disease was investigated. In 66 of 320 liver biopsy specimens a continuous IgA pattern was observed. Alcoholism was mentioned in the cases of 50 of the 66 patients (76%). The biopsy specimens in the remaining 254 cases continued scanty detectable IgA (discontinuous pattern) or none. In the latter group only eight patients (3%) had histories of alcoholism. A direct correlation between a continuous IgA pattern in the hepatic sinusoids and alcohol abuse is thus inferred (P less than 0.001). Additional findings of the concomitant occurrence of IgA in the perisinusoidal linings of the liver, the wall of superficial cutaneous capillaries, capillaries of the gut, and the glomerular mesangium in association with alcoholic hepatic disease further substantiates the concept of the existence of an IgA-associated disease.
Asunto(s)
Hepatitis Alcohólica/inmunología , Especificidad de Anticuerpos , Técnica del Anticuerpo Fluorescente , Hepatitis Alcohólica/diagnóstico , Humanos , Inmunoglobulina A/análisis , Hígado/inmunología , Hepatopatías Alcohólicas/inmunologíaRESUMEN
Skin and kidney biopsies were performed on 262 patients with various nephropathies. In 45 skin biopsy specimens finely granular deposits of predominantly IgA and late-acting complement factors were detected in the walls of superficial capillaries, sometimes concomitantly with IgM, IgG, C4 or a combination of these proteins. Twelve of the 45 patients presented with anaphylactoid purpura and the majority of the other 33 patients had either recurrent macroscopic or microscopic hematuria. The renal lesions in 32 of these 45 patients consisted of focal segmental intracapillary proliferation. In 35 the kidney biopsy specimen showed mesangial deposits of IgA; in one case IgA was deposited along the glomerular basement membrane. In only three of the remaining 217 patients without cutaneous IgA deposits were typical mesangial IgA deposits found. The close correlation between IgA deposits in cutaneous vessels and focal segmental intracapillary proliferation with mesangial IgA deposits suggests that immunofluorescence examination of skin biopsy specimens could prove of diagnostic value. The results provide additional evidence for a close pathogenic relationship between IgA-associated glomerulonephritis and anaphylactoid purpura.
Asunto(s)
Capilares/inmunología , Inmunoglobulina A/análisis , Enfermedades Renales/inmunología , Piel/inmunología , Adulto , Capilares/patología , Niño , Complemento C4/análisis , Técnica del Anticuerpo Fluorescente , Glomerulonefritis/inmunología , Hematuria/inmunología , Humanos , Vasculitis por IgA/inmunología , Vasculitis por IgA/patología , Glomérulos Renales/inmunología , Glomérulos Renales/patología , Piel/irrigación sanguínea , Piel/patologíaRESUMEN
A case of solar urticaria is described showing: (I) Action spectra for late erythema (MED), late swelling and wealing with one peak of sensitivity for erythema and wealing at 405 nm. (2) No signs of porphyria. (3) Possibly increased skin mast cells. (4) Short-lived post-irradiation fibrin deposition. (5) Haemolysis. (6) Apparent suppression of urticaria with the antihistamine Incidal.