1/47. Systemic infection with Alaria americana (trematoda).Alaria americana is a trematode, the adult of which is found in mammalian carnivores. The first case of disseminated human infection by the mesocercarial stage of this worm occurred in a 24-year-old man. The infection possibly was acquired by the eating of inadequately cooked frogs, which are intermediate hosts of the worm. The diagnosis was made during life by lung biopsy and confirmed at autopsy. The mesocercariae were present in the stomach wall, lymph nodes, liver, myocardium, pancreas and surrounding adipose tissue, spleen, kidney, lungs, brain and spinal cord. There was no host reaction to the parasites. Granulomas were present in the stomach wall, lymph nodes and liver, but the worms were not identified in them. hypersensitivity vasculitis and a bleeding diathesis due to disseminated intravascular coagulation and a circulating anticoagulant caused his death 8 days after the onset of his illness.- - - - - - - - - - ranking = 1keywords = vasculitis (Clic here for more details about this article) |
2/47. Demonstration of reactivity to airborne and food allergens in cutaneous vasculitis by variations in fibrinopeptide a and other blood coagulation, fibrinolysis and complement parameters.In a 32-year-old woman and a 40-year-old man with cutaneous vasculitis, etiological allergic responses to foods and airborne allergens were found. During provocation tests, observations were made on blood levels of fibrinopeptide a(FPA) and coagulation factors, fibrinogen degradation products (FDP) and serum complement components. skin biopsies were taken for microscopic and immunofluorescence analysis. In case 1, anaphylactoid allergy to milk and reaginic and anaphylactoid hypersensitivity to grass pollens were found. Dermal provocations with grass pollens gave arthralgia, hematomas, serum C3 fluctuation, factor vii reduction and fibrinolysis. During peroral milk challenge, transient increases in FPA and FDP levels were observed before symptoms appeared. In case 2, anaphylactoid hypersensitivity responses to bacteria, animal danders, foods and pollens were found. Two inhalations with sheep-wool extract resulted in a typical skin eruption. The first also gave an early reduction of C3 and then FPA liberation. Nasal birch-pollen test gave an increase of FPA in the latent period and then typical nodules. At least no low molecular weight FDP were detected during provocations. In patients with vasculitis reactions to exogenous allergens, FPA and FDP estimations after provocations may discriminate harmful from innocuous allergens and reveal individual response patterns in coagulation and fibrinolysis systems.- - - - - - - - - - ranking = 6keywords = vasculitis (Clic here for more details about this article) |
3/47. Temporal artery biopsy in herpes zoster ophthalmicus with delayed arteritis.A 58-year-old man developed herpes zoster ophthalmicus with delayed hemiparesis. Temporal artery biopsy confirmed the presence of a vasculitis. Electron microscopy of the temporal artery failed to reveal viral particles. herpes zoster ophthalmicus with delayed arteritis appeared to be a contiguous spread of vasculitis to the carotid system and not a direct viral invasion.- - - - - - - - - - ranking = 2keywords = vasculitis (Clic here for more details about this article) |
4/47. Effect of penicillamine treatment on immune complexes in two cases of seropositive juvenile rheumatoid arthritis.A correlation has previously been observed between the presence of enhancing complexes and cutaneous vasculitis in rheumatoid arthritis. Two parients with seropositive juvenile rheumatoid arthritis are described in whom enhancing complexes were detected before the appearance of cutaneous vasculitis. Their contrasting response to penicillamine is discussed in relation to the role of of rheumatoid factor and antinuclear antibodies.- - - - - - - - - - ranking = 2keywords = vasculitis (Clic here for more details about this article) |
5/47. Deficiency of the second component of complement (C2) with chronic vasculitis.A patient had complete deficiency of the second component of complement associated with chronic vasculitis and increased susceptibility to infection. We discuss here results of the complement profile, histocompatibility typing, and studies of the functional properties of patient plasma or serum in chemotaxis and opsonization in relation to the disease entity and host susceptibility to infection.- - - - - - - - - - ranking = 5keywords = vasculitis (Clic here for more details about this article) |
6/47. skin fibrinolytic activity in cutaneous and systemic vasculitis.Study of involved and uninvolved skin from patients with necrotizing vasculitis revealed diminished tissue fibrinolytic activity deposition of immunoreactants in involved skin. In these patients, the depletion of tissue fibrinolytic activity is probably the result of vessel injury secondary to the local deposit of immunoreactants. In addition, there was diminished tissue fibrinolytic activity in uninvolved skin from patients with and without clinical skin involvement, unassociated with the deposition of immunoreactants. The precise mechanism for diminished tissue lytic activity in these latter patients is not known, but it may be associated with generalized activation of the coagulation and fibrinolytic mechanisms that result in local depletion of tissue fibrinolytic activity. These local changes may aggravate the clinical course of the disease as well as inhibit the healing of the lesions.- - - - - - - - - - ranking = 5keywords = vasculitis (Clic here for more details about this article) |
7/47. Vascular events associated with alpha interferon therapy.Alpha Interferon (IFN) is a biological agent used for the therapy of an increasing number of diseases, either as an established effective therapeutic tool or in the context of clinical trials. The use of IFN may be complicated by serious adverse reactions. We describe here the clinical course of a variety of vasculopathic complications in association with IFN-therapy in 12 patients with the diagnosis of chronic myeloid leukemia and 1 patient with malignant melanoma treated at our institute. Vascular manifestations in these patients include Raynaud's phenomena, digital ulcerations and gangrene, pulmonary vasculitis, pulmonary hypertension and thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS). These reactions occurred after 3 months to 3 years of 3-10 million units (MU) daily IFN therapy. Concomitant administration of hydroxyurea (HU) was noted in 5 patients. Discontinuation of IFN and initiation of immunosuppressive therapy brought about a complete resolution or arrested progression of these reactions. IFN-therapy may be complicated by severe vasculopathic/vasospastic complications that usually improve after its discontinuation. Possible underlying mechanisms for these complications are discussed. The early diagnosis of these complications may be vital and IFN should be immediately discontinued when early signs of these complications become evident.- - - - - - - - - - ranking = 1keywords = vasculitis (Clic here for more details about this article) |
8/47. Cogan's syndrome: a systemic vasculitis.Nonsyphilitic interstitial keratitis with vestibuloauditory dysfunction (Cogan's syndrome) is a rare clinical entity. We have reviewed 53 cases (including one of our own) of this disease. In 72 per cent of the affected patients there was an underlying systemic process, often a vasculitis. Ten per cent had fatal or near fatal aortic valvular disease, which has been shown to be amenable to surgical intervention. Other systemic manifestations have included congestive heart failure, gastrointestinal hemorrhage, adenopathy, splenomegaly, hypertension, musculoskeletal involvement and eosinophilia. The clinical course is extremely variable, ranging from months to over 15 years with a minimal five year survival of 28 per cent. Medical therapy with corticosteroids has been beneficial but has only limited effect on symptoms of vestibuloauditory dysfunction. Cogan's syndrome appears to be a manifestation of a systemic disorder which is often apparent only after long-term follow-up.- - - - - - - - - - ranking = 5keywords = vasculitis (Clic here for more details about this article) |
9/47. The role of additives in allergic vasculitis during intravenous hyperalimentation.A 39-year-old woman who had previously undergone a jejunoileal bypass for morbid obesity was receiving intravenous hyperalimentation. The patient developed allergic vasculitis while receiving fluid which contained a multi-vitamin solution. Rechallenge with this preparation resulted in an exacerbation of her skin lesions. The possible role of such additives in the development of unusual hypersensitivity reactions is discussed.- - - - - - - - - - ranking = 5keywords = vasculitis (Clic here for more details about this article) |
10/47. Necrotizing vasculitis: a circulating immune complex producing inflammatory skin lesions.A patient with acute necrotizing vasculitis is described in whom tests for circulating immune complexes were negative. The patient's serum injected intradermally produced lesions which closely resembled those occurring spontaneously. When the serum was fractionated, the skin-reactive fraction was found to be associated with IgG, but was of a higher molecular weight than normal IgG. Immunofluorescent studies showed that lesions induced by this active fraction contained IgG and complement in the epidermal basement membrane zone and within the small dermal vessels. We conclude that an immune complex of relatively low molecular weight is present in the active fractions, and capable of initiating the lesions of acute necrotizing vasculitis.- - - - - - - - - - ranking = 6keywords = vasculitis (Clic here for more details about this article) |
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