Circulating immune complexes and serum complement in allergic granulomatous angitis:a case report and review of the literature

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A case of allergic granulomatous angitis (Churg and Strauss) was reported and the role of circulating immune complexes (CIC) and serum complement in pathogenesis of the disease was discussed.A 30-year-old woman with history of bronchial asthma for 2 years duration developed abdominal pain, diarrhea, melena, fever, marked emaciation and weakness of the extremities. The clinical investigation revealed pulmonary infiltrates, multiple gastric ulcers, marked leucocytosis with eosinophilia, thrombocytosis, proteinuria, microcopic hematuria and mononeuritis multiplex. The histlogical examination of the specimens obtained by musclar and renal biopsy demonstrated vasculitis with eosinophilic infiltration. Corticosteroid therapy (prednisolone 40 mg/day orally) induced rapid clinical improvement.CIC estimated by Raji cell assay and immunofluorescent study on polymorphonuclear leucocytes (PMN-IF) were positive in the sample of the serum obtained at the time of admission. In the clinical course of the patient, CIC detected with PMN-IF method were decreased in level during the period of initial corticosteroid therapy but reincreased as diminishing the dose of prednisolone without clinical exacervation.The components of the serum complement, C3, C4, C5 and C9 showed rather high value in the initial period of the disease and decreased gradually as administration of prednisolone, but never showed abnormal low level. Serum Clq level, which was slightly lower than normal in the initial period, showed no significant change in the clinical course of the case.These findings suggest that CIC play some role in pathogenesis of allergic granulomatous angitis, although their corelation with serum complement is not yet clear.
日本臨床免疫学会の論文

Circulating immune complexes and serum complement in allergic granulomatous angitis:a case report and review of the literature

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