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Query: UMLS:C0042384 (vasculitis)
 20,525 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The skin is very often the target organ of allergic reactions. This may be explained by many immunological competent cells in this organ such as the Langerhans cell, mast cells, lymphocytes, neutrophils and eosinophils. This is especially true for the antigen-presenting Langerhans cell. Therefore in many cases, the skin is a signalling organ for allergic reactions. Examples include food allergy which precipitates with sign and symptoms of skin diseases in about 45% and drug allergy to beta-lactam-antibiotics in about 90%. Also the skin serves as test organ in allergic diseases of other organs such as rhinitis allergica or asthma. Examples include Reibtest, prick-, intracutaneous-, scratch- and patch test. Therefore it is no surprise, that allergic diseases of the skin are the most often diagnosed skin diseases such as urticaria, angioedema, vasculitis, contact dermatitis and atopic dermatitis. At these diseases, their diagnose and therapy and especially the promising progress in research with regard to these diseases which has been obtained during the last years will be focussed in this review.
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PMID:[The skin and allergy]. 944 Oct 25

There are many types of urticaria and the principal form of assessment is by clinical history and examination. Urticarial weal formation involves acute, reversible vasodilatation and increased vascular permeability. If the process is deeper the more diffuse swelling is termed angio-oedema. The major types of urticaria include allergic, physical and idiopathic forms. In allergic urticaria, IgE-mediated degranulation of mast cells results in weals of short duration which typically respond well to antihistamines. Physical urticarias are induced by physical insults including pressure, scratch, cold, etc. The distribution and duration of individual weals may suggest the causal factor. Chronic idiopathic urticaria can be very variable, with individual weals lasting between 90 min and 24 hours. Longer-lasting weals are less responsive to anti-histamines and clearly involve other mediators. When long-lasting weals fade leaving a bruised appearance urticarial vasculitis is present which may only respond to systemic corticosteroids. In a proportion of individuals with chronic idiopathic urticaria, auto-antibodies are present with specificity for the high affinity receptor for IgE or sometimes, for IgE itself. In general laboratory tests for allergic factors or other assessments of general health are completely unhelpful.
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PMID:Assessment of urticaria and angio-oedema. 1044 23

The skin is very often the target organ of allergic reactions. This may be explained by many immunological competent cells in this organ such as the Langerhans cell, mast cells, lymphocytes, neutrophils and eosinophils. This is especially true for the antigen-presenting Langerhans cell. Therefore in many cases, the skin is a signalling organ for allergic reactions. Examples include food allergy which precipitates with signs and symptoms of skin diseases in about 45% and drug allergy to beta-lactam-antibiotics in about 90%. Also the skin serves as a test organ in allergic diseases of other organs such as rhinitis allergica or asthma. Examples include Reibtest, prick-, intracutaneous-, scratch- and patch test. Therefore it is no surprise, that allergic diseases of the skin are the most often diagnosed skin diseases such as urticaria, angioedema, vasculitis, contact dermatitis and atopic dermatitis. At these diseases, their diagnose and therapy and especially the promising progress in research with regard to these diseases which has been obtained during the last years will be focussed in this review.
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PMID:Allergy, skin and environment. 1050 20

Bartonella henselae has only recently been isolated, characterized, and found to be the principal cause of cat-scratch disease (CSD). The availability of specific serologic investigations has allowed the recognition of a spectrum of ocular CSD syndromes that previously were ill defined and considered idiopathic. The primary inoculation complex causing regional lymphadenopathy is represented in the eye by Parinaud's oculoglandular syndrome; B. henselae is the most common cause. Leber's neuroretinitis has been identified for 80 years, and new data suggest that it is commonly a manifestation of CSD; the extent of the association remains to be determined. CSD optic neuritis is also described. The vitreoretinal manifestations include anterior uveitis, vitritis, pars planitis, focal retinal vasculitis, a characteristic retinal white spot syndrome, Bartonella retinitis, branch retinal arteriolar or venular occlusions, focal choroiditis, serous retinal detachments, and peripapillary angiomatous lesions. The pattern of ocular disease in AIDS-associated B. henselae infections is poorly delineated; unusual manifestations include conjunctival and retinal bacillary angiomatosis. The benefit of antimicrobial therapy for CSD in immunocompetent individuals has been difficult to establish, partly because most infections are self limited. Empirically, azithromycin, ciprofloxacin, rifampin, parenteral gentamicin, or trimethoprim-sulfamethoxazole provide the best therapeutic choices to minimize damage to the eye.
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PMID:Ocular manifestations of cat-scratch disease. 1053 81

We studied an acute generalized exanthematous pustulosis (AGEP) due to sulfamethoxazol in a 48-year-old woman with unusual findings in allergy testing. The histological picture provided evidence for a pustular drug eruption and leukocytoclastic vasculitis. Skin testing with sulfamethoxazol was negative for immediate-type reaction (scratch test) and delayed-type reaction (epicutaneous testing). A lymphocyte transformation test (LTT) showed a significant lymphocyte stimulation (stimulation index 5.04/2.61) toward sulfamethoxazol (200/100 mg/ml) by measuring the rate of built-in tritium-thymidine in the DNS of the patients lymphocytes, implicating a drug-specific hypersensibility of lymphocytes; we could be dealing with a combined type III and IV reaction by Coombs and Gell in this case. LTT may play a possible role in the determination of drug allergy in AGEP despite negative skin testing.
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PMID:Acute generalized exanthematous pustulosis due to sulfamethoxazol with positive lymphocyte transformation test (LTT). 1286 54

Bartonellae belong to less known causal agents of many human diseases. They are gram-negative bacteria growing slowly on culture media enriched with hemin or bovine serum. The genus Bartonella, which currently involves more than 15 species, is present worldwide. Bartonellae live in natural foci in dependence on the occurrence of natural host (rodents, felines, canidae, human) and insect vector (flea, tick, louse). By reservoir animals they usually cause permanent intraerythrocytic bacteraemia without system inflammation symptoms. A classical example of a human disease is cat scratch disease (CSD) caused by Bartonella henselae and characterised by regional lymphagoitis and lymphadenitis. Increasing interest is being devoted to the ability of Bartonella sp. (e.i. B. quintana) to cause the opportune infections with diverse clinical manifestation: bacillary angiomatosis, specific liver and spleen vasculitis (peliosis hepatis, splenis), endocarditis and others. The issue of Bartonella infections is relatively new and its importance is still growing with increasing knowledge in this field.
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PMID:[Bartonelloses]. 1555 48

Bartonella henselae, the causative agent of cat scratch disease and bacillary angiomatosis, is associated with an expanding spectrum of diseases. Here, we report on a 40-year-old patient suffering from chronic recurrent painful ulcers of the toes, distal axonal sensomotor polyneuropathy and Raynaud's phenomenon. Biopsy of the sural nerve demonstrated an axonal neuropathy with a neurogenic muscular atrophy. Treatment with high dose corticosteroids had no beneficial effect. A biopsy taken from a recurring ulcer 7 years after the beginning of the disease revealed superficial ulcerated hyperkeratosis with subepithelial proliferation of small vessels compatible with a diagnosis of verruca peruana, however, without detection of microorganism. Serologic analysis revealed an elevated IFT titer of 1:1,024 against B. henselae. Treatment with erythromycin induced healing of the ulcer, remission of the vasculitis and the polyneuropathy, and a decline of the IFT titer. This case illustrates that B. henselae infection should be considered in patients with vasculitis and polyneuropathic syndromes.
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PMID:Chronic vasculitis and polyneuropathy due to infection with Bartonella henselae. 1740 16

This report describes the characterization of a Bartonella henselae abortion in an equine fetus by gross, histologic, immunohistochemical, ultrastructural, and molecular methods. Bartonella henselae can cause cat scratch disease, bacillary angiomatosis, bacillary peliosis, and endocarditis in humans and other animals. The bacterium has been isolated from several mammalian species but only recently from equids; however, it has not been linked to abortion in equids. An aborted equine fetus exhibited necrosis and vasculitis in multiple tissues, with intralesional Gram-negative short-to-spirillar bacteria. Nucleotide sequence analysis of the bacterial 16S rRNA gene amplified from the DNA extracted from fetal tissues revealed 99.9% homology to that of B. henselae. The presence of B. henselae in the fetal tissues was further confirmed by polymerase chain reaction amplification and nucleotide sequence analysis of other Bartonella species-specific genes. Microorganisms were immunohistochemically labeled with a monoclonal antibody to B. henselae and were ultrastructurally characterized. Attempts to detect known causative agents of equine abortion were unsuccessful. Given the severity of vasculitis and the presence of intralesional bacteria, we concluded that B. henselae infection caused the abortion of this foal.
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PMID:Identification of Bartonella henselae in an aborted equine fetus. 1926 40

We report on 2 patients with unusual retinal manifestations of cat scratch disease (CSD), caused by Bartonella henselae. Case 1. A 42-year-old farmer presented with a 5-day history of blurred vision in his right eye. Right visual acuity was 20/25. Fundus examination of the right eye revealed mild vitreous hemorrhage and diffuse retinal hemorrhages in the mid-peripheral retina. Fluorescein angiography showed multiple vasculitic occlusions in the same area. A blood sample taken on the day of examination revealed the presence of immunoglobulin (Ig)M and IgG to B. henselae. Oral azithromycin was given for 8 days. One month later, right visual acuity was 20/20, the vitreous and retinal hemorrhages resolved, and arteriolar attenuation and sclerosis was observed in the peripheral temporal retina. Case 2. A 66-year-old craftsman with systemic hypertension and hypercholesterolemia complained of sudden visual loss (light perception) in his left eye. Fundus evaluation and fluorescein angiography revealed central retinal artery occlusion (CRAO) in the affected eye. About 2 weeks earlier, he had been bitten and scratched on his right hand by a stray cat. Serologic testing detected the presence of IgM to B. henselae. Oral azithromycin was given for 6 days. One month later, left visual acuity was hand motion. Ophthalmologists should be aware that unusual ocular complications associated with CSD include vitreous hemorrhage with retinal vasculitis and isolated CRAO. Vitreous hemorrhage and retinal vasculitis may be the only clinical manifestation of CSD.
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PMID:Unusual retinal manifestations of cat scratch disease. 2126 28

We report an atypical presentation of ocular cat scratch disease (CSD) in an 8-year-old Caucasian male who presented with localised retinal arterial vasculitis and associated retinal oedema. His history of headaches, frequent contact with a kitten and a high Bartonella henslelae titre confirmed the diagnosis of CSD. Over an 18-month follow-up period, his best corrected visual acuity in the affected eye improved from 20/30-2 to 20/25+3 without treatment; however, the affected retinal artery remained sheathed.
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PMID:Localised retinal vasculitis in cat scratch disease. 2168 69


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