Asli Akin Belli1, Emine Dervis2. 1. Haseki Training, Research Hospital, Department of Dermatology Adivar Caddesi Aksaray, 34096 Istanbul, Turkey. 2. Kafkas University, Kafkas Medical School, Department of Dermatology.
Abstract
BACKGROUND: Henoch-Schönlein purpura (HSP) is a systemic and immune complex-related leukocytoclastic vasculitis. A positive correlation has been found between IgM deposition along with IgA in skin lesions diagnosed by direct immunofluorescence (DIF) and renal involvement with HSP. OBJECTIVES: We sought to investigate the relationship between the systemic associations of the disease and the severity of the skin lesions, as well as the immune deposition findings of the lesional skin provided by DIF in patients with HSP. MATERIALS & METHODS: Between 2001 and 2012, 47 patients with HSP were investigated at our dermatology clinic. Epidemiologic data, laboratory findings, localizations of the palpable purpura, existence of bulla or necrosis in the skin lesions, accompanying systemic involvement, and DIF findings of skin biopsy specimens were recorded. RESULTS: Of the 47 patients 22 were men and 25 were women (age range 16-88 years, mean 42.2). Among all cases with skin involvement, we found 22 (46.8%) articular involvement, 20 (42.6%) renal involvement and 12 (25.5%) gastrointestinal tract involvement. The frequency of bulla and/or necrosis in the skin lesions was significantly high in patients with gastrointestinal and renal involvement (p<0.05). The risk of renal involvement was significantly high in patients whose DIF examination revealed IgM deposition (p<0.05). No association was found between systemic involvement and IgG, complement 3 (C3) and fibrinogen deposition. CONCLUSION: Patients with HSP, having bullous and/or necrotic lesions and whose skin DIF investigations reveal IgM deposition along with IgA, should be surveyed for the risk of renal involvement.
BACKGROUND: Henoch-Schönlein purpura (HSP) is a systemic and immune complex-related leukocytoclastic vasculitis. A positive correlation has been found between IgM deposition along with IgA in skin lesions diagnosed by direct immunofluorescence (DIF) and renal involvement with HSP. OBJECTIVES: We sought to investigate the relationship between the systemic associations of the disease and the severity of the skin lesions, as well as the immune deposition findings of the lesional skin provided by DIF in patients with HSP. MATERIALS & METHODS: Between 2001 and 2012, 47 patients with HSP were investigated at our dermatology clinic. Epidemiologic data, laboratory findings, localizations of the palpable purpura, existence of bulla or necrosis in the skin lesions, accompanying systemic involvement, and DIF findings of skin biopsy specimens were recorded. RESULTS: Of the 47 patients 22 were men and 25 were women (age range 16-88 years, mean 42.2). Among all cases with skin involvement, we found 22 (46.8%) articular involvement, 20 (42.6%) renal involvement and 12 (25.5%) gastrointestinal tract involvement. The frequency of bulla and/or necrosis in the skin lesions was significantly high in patients with gastrointestinal and renal involvement (p<0.05). The risk of renal involvement was significantly high in patients whose DIF examination revealed IgM deposition (p<0.05). No association was found between systemic involvement and IgG, complement 3 (C3) and fibrinogen deposition. CONCLUSION:Patients with HSP, having bullous and/or necrotic lesions and whose skin DIF investigations reveal IgM deposition along with IgA, should be surveyed for the risk of renal involvement.
Entities:
Keywords:
Henoch-Schönlein purpura; IgM; direct immunofluorescence; palpable purpura; renal involvement
Authors: Caroline Maris Takatu; Antonio Pedro Ribeiro Heringer; Valéria Aoki; Neusa Yuriko Sakai Valente; Paula Cristina de Faria Sanchez; Jozélio Freire de Carvalho; Paulo Ricardo Criado Journal: Immunol Res Date: 2017-02 Impact factor: 2.829
Authors: Evangeline Pillebout; Agnès Jamin; Hamza Ayari; Pierre Housset; Melissa Pierre; Virginia Sauvaget; Denis Viglietti; Georges Deschenes; Renato C Monteiro; Laureline Berthelot Journal: PLoS One Date: 2017-11-30 Impact factor: 3.240