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应用抗IgA、抗IgG、抗IgM、及抗C_3血清的直接荧光法研究了479例患者,有20.2％的病例发现真皮血管的荧光现象。观察到三型血管荧光现象:即卟啉样《套筒状》(18％)颗粒型(76％)及血管周围团块型(6％)。卟啉样型主要见于红斑性狼疮中的IgG及暴露的健康皮肤。根据Ig沉积的类别及病因讨论了颗粒型(IgG为6％,IgA31％,IgM48％,C_371％),颗粒形的荧光现象见于96％(26/27)具有紫癫的坏死性血管炎,8％(3/38)慢性红斑狼疮,31％(10/32)系统性红斑狼疮,25％(6/24)类风湿性多关节炎,在其它胶原性疾病及大癌性疾病中较罕见。IgA的沉积无特异性,但对类风湿紫癜似乎有独特的意义;血管荧光现象同样发现于中毒性皮肤病,有免疫复合物的肝脏病,少数痒疹,特发性血小板减少性紫癜及Osler心内膜炎。在一些没有免疫复合物参予发病的疾病中,此种血管荧光现象是罕见的。用直接免疫荧光法(IFD)来揭示真皮浅层及中层的血管荧光现象并不少见。最常见的血管标记是颗粒形并在血管壁中能显现免疫复合物的沉积。在许多疾病过程中以及健康人曾揭示出这种标记,并讨论了其特异性。我们于1978年4月至1979年7月用抗IgA、抗IgG、抗IgM及抗C_3血清研究了479名病人的皮肤,以便了解血管荧光反应的出现对于指导临床医生在其诊断及病因推断中是否完全可靠。
In 479 patients, anti-IgA, anti-IgG, anti-IgM and anti-C_3 serum were used to investigate the fluorescence of dermal vessels in 20.2% of cases. Three types of vascular fluorescence were observed: porphyrin-like “sleeve” (18%) granules (76%) and perivascular briquettes (6%). Porphyrins are mainly found in lupus erythematosus (IgG) and exposed healthy skin. According to the type and etiology of Ig deposition, the particle types (IgG 6%, IgA 31%, IgM 48%, C 371%) were discussed. Granular fluorescence was found in 96% (26/27) of patients with necrotizing vasculitis with purple epilepsy. % (3/38) of chronic lupus erythematosus, 31% (10/32) of systemic lupus erythematosus, 25% (6/24) rheumatoid arthritis, rare in other collagen diseases and large cancerous diseases. The deposition of IgA is non-specific but appears to have a unique significance for rheumatoid purpura; vascular fluorescence is also found in toxic dermatosis, liver disease with immune complexes, prurigo, idiopathic thrombocytopenic purpura, and Osler’s heart Endometritis. In some diseases that are not involved in the pathogenesis of immune complexes, this phenomenon of vascular fluorescence is rare. Direct immunofluorescence (IFD) to reveal the superficial and middle dermal vascular fluorescence phenomenon is not uncommon. The most common vascular markers are granular and show the deposition of immune complexes in the blood vessel wall. This marker has been uncovered during many diseases and in healthy people and its specificity has been discussed. We studied the skin of 479 patients with anti-IgA, anti-IgG, anti-IgM, and anti-C_3 sera from April 1978 to July 1979 to understand the presence of vascular fluorescence responses to guide clinicians in their diagnosis and etiology Is it completely reliable?