ALLERGIC, ANAPHYLACTOID AND TOXICOREACTIVE VASCULITES

By | March 13, 2020

This group includes a variety of conditions, syndromes and
diseases, clinically and morphologically expressed mainly
changes in the blood vessels that arise as a result of
tate allergic, anaphylactoid, and toxico-allergic reactions.
With them, arteries, arterioles, capillaries and
veins, and for the manifestation of these lesions is especially important
Nie has a special vascular predisposition (poor resistance
walls, their permeability, degeneration, impaired viscosity and
blood thaw, tendency to endotheliitis and other inflammatory
phenomena, blood clots, spastic conditions, etc.).
Most of these diseases, due to unclear etiology, consider
or as allergies in the broad sense of the word, Or how
anaphylactoses, or as a special kind of collagenosis, which does not clarify
into this question.

Various classifications and groupings of these
Levania, separate varieties stand out, still very doubtful
as nosological units.
Some authors (#so! Ai – Wabati, Oiregga!) Group these
diseases according to clinical and morphological characteristics, or according to which
vessels of the skin and subcutaneous tissue, mainly at the same time
others, (Ruitter, Miescher –– b1YugsK, etc.) on histopathological
features, the third – according to the type of hypersensitivity reactions, etc.
None of the proposed. classifications cannot be considered to be fully
satisfactory.

In our brief description of the diseases, we will try to distribute
divide them by etiology and pathogenesis, t. €. MO type of reaction, character
that cause individual syndromes and diseases, especially since clinically
The morphological characteristics of the rarest of them are
rub off separately.

A common, most significant feature of these nosological
units is a vascular lesion similar to their lesion in
experimental phenomena $ apage !, Richer w Portier, Arthus’a,
Shwartzmann’a, Pirquet, Benda ¢ comp. u Op. (anadunaThyeckuii 10K,
serum sickness, nonspecific hypersensitization, histami-
nophilaxia and histaminopexy, antigen-antibody reactions, medicament
toxic toxic allergy).

Another important sign by which these diseases are grouped
vania, are some similar histopathological signs,
characteristic of allergic reactions [reporting and degeneration of endo-
Telia, the so-called fibrinoid collagen degeneration, necrosis of the vessel
Dov, leukocytoclasia (powdery decay of nuclei of leukocytes), zozi-
tissue or blood nophilia, blood clots, proliferation of endothe-
lia, lymphoid infiltrates, extravasates, hemosiderosis, necrosis, etc.).

Clinically highly polymorphic, this group
vasculitis has some common signs inherent in vascular changes (color, various hemorrhages, nodes, vesicles with hemorrhagic content, necrosis, hemosideric pigment –
tion, thromboangiitis, etc.), and some of them are clearly
accompanied or alternated with changes in other organs besides
skin (arthropathy, shock phenomena, glomerulonephritis, etc.).
Typically, with this type of vasculitis, samples are of great importance.
Rumpel — Leede !, Mac C1ige-A! Aps, with methylene blue, oscillometry,
skin thermometry, reactions to autostreptolysins, peakuus Coombs,
histamine-neptic index, prothrombin time, coagulability
blood and others To determine the type of hypersensitivity reactions,
Some biochemical studies of changes in collagen (mu-
copolysaccharides, chondroitin-sulfuric and hyaluronic acid, relative
hyaluronidase – hyaluronic acid, ratio of blood proteins).
And finally, you should always analyze the condition: neuroreflex
activities, the impact of a variety of atmospheric and climatic
factors (season), and also try to determine
genes, allergens and antigens that affect the vascular
system (histamine and histamine-like substances, protein
products, heparin, autoallergens, certain medications and chemicals
society, etc.).

Reactogens, allergens, antigens (these terms are for us He
unambiguous), both exo- and endogenous, which in this case
can cause such reactions and changes on the part of the vessels,
They are: heterogeneous or endogenous pains, infectious agents (
fecal infections, subsepsis, viruses), trophallergens, pneumoallergens,
chemicals – drugs, autoaggressins and isoantibodies (end-
gene protein products), capillarotoxic substances, physical
meteorological and atmospheric factors in combination with a polyallergenic
us and others. As for the vascular predisposition, which
may be congenital or acquired, then special significance here
have vasomotor vascular lability, ›vasospastic reactions,
vascular instability and their permeability, impaired vasomotor
reflex activity, endocrine profile, age factor,
blood coagulation, etc.

From an etiological point of view, these vasculitis can be distributed
pour as follows:

1. Infectious (focal infections, subsepsis, tuberculosis, etc.).
Such diseases can be attributed to the determination of etiopathogenesis.
like: purpura 5svbo e! t – NeposK’a, the three-symptom disease of Sotsrego! –
Duperrat, KiTsega arteriolitis knotty necrotic dermatitis Wer-

1 vega capillary KozKapa leukocytoclastic microbids Miescher-
ZogsK’a, some vascular hypodermatitis (Oiregga *, Oerov, Sotsrego!),
some septic erythema nodosum and even malignant
papulosis Oero $ ‘a and purpous tuberculides of Sotsrego !.

2. Toxico-allergic (caused most often by drugs –
sulfonylamides, irgapirin, butadine, pyramidone, procaine,
iodine, etc.). These are some erythema nodosum, toxic pur-
puri, toxico-allergic acute necroepidermolysis, some toxic
coallergic capillaritis caused by trophallergens and drug
states, etc.
3. Anaphylactic (such as the reactions of Richet, Arthus’a, Sanarelli—
Schwarzman and others). These are likely: nodular vasculitis
Montgomery – O’Leary, HekoTopble Migratory Phlebitis, Allergic
Pan-vasculitis NagKauu, granulomatous vasculitis Enega, hemorrhagic
serum sickness.

4. Autoimmune (endogenous allergens and antigens). From here
worn: knotty panvasculitis, Mopdog’s phlebitis, erythema migrans,
erythema elevatum diutinum.

5. Allergic vasculitis, in which can play the role of
personal factors like: irradiation, light, radiant energy, meteorological
logical influences, heat.

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