[Immunocomplex vasculitis].

Abstract

The clinician suspects immunocomplex vasculitis when he cannot find a common denominator for the concurrent affection of various neighbouring organs and tissues. These affections result from the inflammatory response of the organism to the deposition of non-phagocytized circulating immunocomplex into the vascular wall. Despite the delicacy of attempts to classify them, the author tried to differentiate them into non-progressing immunocomplexes vasculitis, which recedes, and progressing immunocomplex vasculitis which may be either primary or secondary. Among primary ones he includes nodose polyarteritis and its granulomatous variant, Churg-Strauss' disease, Henoch-Schönlein anaphylactoid purpura and granulomatous vasculitis of the Wegener granulomatosis type, Horton's temporal arteritis, Takayasu's pulseless disease and Winiwarter-Buerger's obliterating thromboangiitis, which may be of the peripheral or more rarely the visceral type. Secondary progressing vasculitis is encountered in so-called "collagenoses" (e.g. systemic lupus erythematodes), where the clinical picture is to a considerable extent conditioned by vasculitis. The clinical picture is due to the generalized affection of the microcirculation. Symptoms of ischaemic affection of all organs and tissues may be encountered. A typical feature are different types of damage of the same adjoining system, e.g. a combination of asymmetric central and peripheral pareses in affections of the nervous system. The author discusses the most frequent clinical pictures, the importance of different examination procedures and therapeutic possibilities. Assessment of the diagnosis of immunocomplex or autoaggressive systemic disease is very difficult, as a typical picture corresponding clearly to a defined nosological unit is encountered rarely.(ABSTRACT TRUNCATED AT 250 WORDS)