Kutanöz Küçük Damar Vaskülitlerinde Direkt İmmunfloresan (Dif) Mikroskopi Bulguları: Tek Merkeze Ait Deneyimler
Yükleniyor...
Tarih
2018
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Küçük damar kutanöz vaskülitlerinde (KKV) direkt immunfloresan mikroskopide (DİF) immun depolanmalar (özellikle IgG, IgM, IgA ve Kompleman C3) gözlenebilir. Dünya literatüründe çeşitli pozitiflik oranları bildiren çalışmalar mevcuttur. Çalışmamızda kliniğimize ait KKV’lerinin DİF mikroskopi sonuçlarını sunmayı amaçladık. Gereç ve yöntem: Vaskülit ön tanısı ile biopsi ve DİF tetkiki yapılan, histopatolojik olarak KKV’i mevcut olan toplam 121olgu retrospektif olarak çalışmaya dahil edildi. Olgular klinik verileri ve Chapel Hill Consensus Conference vaskülit sınıflaması göz önünde bulundurularak toplam 6 gruba ayrıldı. Bazal membran ya da perivasküler (PV) alanda en az bir depolanma ‘DİF pozitif’ olarak kabuledildi. Tüm olgularda DİF IgG, IgM, IgA ve Compleman C3 depolanmalarının dağılımları, oranları ve gruplarda en az bir immun depozitin bulunma durumu belirlendi. Lökositoklazis bulunduran ya da eozinofil bulunduranlar ayrı grup yapılarak diğerleri ile immun depolanmalar açısından istatistiksel olarak karşılaştırıldı. Bulgular: Tüm olgularda DİF pozitifliği %58.7 (n:71/121) idi. Lökositoklastik vaskülit olgularının %50.9’unda (n:28/55), nonspesifik KV olgularının%67.4’ünde (n:31/46), ürtikeryal vaskülit olgularının %44.4(n:4/9)’ünde, livedoid vaskülit olgularının %75 (n:3/4)’inde, henochschonlein purpurası (HSP) olgularının (n:5/5) %100’ünde DİF pozitifti.2 vaskülopati olgusunda depolanma yoktu. Lökositoklazis ve eozinofil mevcudiyeti ile immun depolanmalar arasında herhangi bir ilişki yoktu. En fazla biriken depozit C3 iken, HSP olgularında IgA depolanma oranı %100’dü. Sonuç: KKV’lerinde gözardı edilemeyecek yüksek DİF pozitiflik oranları (özellikle C3) tespit edildi. HSP olgularında DİF ile IgA depozit tespiti tanı için oldukça önemlidir. KKV’lerde DİF tetkikinin, klinik ve histopatolojik incelemeye ek olarak uygulanması faydalı olabilir.
Background: İmmun deposits (especially IgG, IgM, IgA and Compleman C3) can be observed under direct immunofluorescence microscopy (DIF) in many patients with cutaneous small vessel vasculitis (CSV). There are some studies reporting various positivity rates in the literature. In this study, we aimed to present the results of DIF microscopy of CSV cases in our ınstitute. Materyal and Methods: A total of 121patients with CSV were included retrospectively in this study. All the cases have skin biopsyfor DIF and histopathological examination and clinical data. A total of 6 groups were formed considering the clinical data of the cases and the Chapel Hill Consensus Conference vasculitis classification. The accumulation of atleast one of the immun deposits (IgG, IgM, IgAve C3) in basal membrane or perivascular (PV) field was assessed as ‘DIF positive’. The relationship between the presence of eosinophil and leucocytoclasia and the accumulation of immun deposits was investigated statistically. Results: DIF was positive in 58.7% (n:71/121) cases. DIF was positive in 50.9% (n: 28/55) of leukocytoclastic vasculitis cases, 67.4% (n: 31/46) of nonspecific CV cases, 44.4% (n: 4/9) of urticarial vasculitis cases and 75% of livedoid vasculitis cases (n: 3/4), 100% (n: 5/5) of henoch schonlein purpura (HSP) cases. There was not any accumulation in vasculopathy cases (n:2). There was not any relationship statistically between the presence of eosinophil and leucocytoclasia and the accumulation of immun deposits. The highest immun accumulation was C3 and the rate of IgA accumulation in HSP was 100%. Conclusion: In CSVs, high DIF positivity rates (especially C3) were determined. The determination of IgA deposits with DIF is very important for diagnosis of HSP. Performingof DIF in addition to clinical and histopathologic examination may be useful in CSVs.
Background: İmmun deposits (especially IgG, IgM, IgA and Compleman C3) can be observed under direct immunofluorescence microscopy (DIF) in many patients with cutaneous small vessel vasculitis (CSV). There are some studies reporting various positivity rates in the literature. In this study, we aimed to present the results of DIF microscopy of CSV cases in our ınstitute. Materyal and Methods: A total of 121patients with CSV were included retrospectively in this study. All the cases have skin biopsyfor DIF and histopathological examination and clinical data. A total of 6 groups were formed considering the clinical data of the cases and the Chapel Hill Consensus Conference vasculitis classification. The accumulation of atleast one of the immun deposits (IgG, IgM, IgAve C3) in basal membrane or perivascular (PV) field was assessed as ‘DIF positive’. The relationship between the presence of eosinophil and leucocytoclasia and the accumulation of immun deposits was investigated statistically. Results: DIF was positive in 58.7% (n:71/121) cases. DIF was positive in 50.9% (n: 28/55) of leukocytoclastic vasculitis cases, 67.4% (n: 31/46) of nonspecific CV cases, 44.4% (n: 4/9) of urticarial vasculitis cases and 75% of livedoid vasculitis cases (n: 3/4), 100% (n: 5/5) of henoch schonlein purpura (HSP) cases. There was not any accumulation in vasculopathy cases (n:2). There was not any relationship statistically between the presence of eosinophil and leucocytoclasia and the accumulation of immun deposits. The highest immun accumulation was C3 and the rate of IgA accumulation in HSP was 100%. Conclusion: In CSVs, high DIF positivity rates (especially C3) were determined. The determination of IgA deposits with DIF is very important for diagnosis of HSP. Performingof DIF in addition to clinical and histopathologic examination may be useful in CSVs.
Açıklama
Anahtar Kelimeler
Kutanöz, Küçük damar, Vaskülit, Direkt immunfloresan, İmmun depozit, Cutaneous, Small vessel, Vasculitis, Direct immunofluorescence, İmmun deposit
Kaynak
Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
25
Sayı
2
Künye
Oltulu, P., Uğur, A., Özer, İ., Kılınç, F., Esen, H. H., Fındık, S., Ataseven, A., İyisoy, M. S., Avunduk, M. C., Balevi, Ş. (2018). Kutanöz küçük damar vaskülitlerinde direkt immunfloresan (Dif) mikroskopi bulguları: Tek merkeze ait deneyimler. Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi, 25, 2, 176-184.
