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April 1984

Bowel-Associated Dermatosis-Arthritis Syndrome: Immune Complex-Mediated Vessel Damage and Increased Neutrophil Migration

Author Affiliations

From the Department of Dermatology (Drs Jorizzo and Apisarnthanarax and Mr Dinehart), the Division of Immunology and Allergy, Department of Pediatrics (Dr Schmalstieg and Ms Rudloff), the Division of Immunology and Rheumatology, Department of Internal Medicine (Drs Daniels and Gonzalez), and the Division of Renal Immunopathology, Department of Pathology (Dr Cavallo), University of Texas Branch at Galveston.

Arch Intern Med. 1984;144(4):738-740. doi:10.1001/archinte.1984.00350160088016

• In a recent report we described a syndrome, identical to bowel-bypass syndrome, that occurred in four patients who had not had bypass surgery. Herein, circulating immune complexes (CICs) and neutrophil migration are evaluated in three of those four patients to test the hypothesis that the cutaneous lesions might have resulted from interaction between immune complex—mediated vessel damage and increased neutrophil migration. In vitro assays indicated that CICs were present in one of two patients and "histamine trap" test evidence for CICs was present in both patients tested. Although serum from the three patients appeared to increase neutrophil movement, statistically significant increases were not observed when data were pooled in this small study group. Preliminary results suggest that immune complex—mediated vessel damage, followed by extensive accumulation of neutrophils, may cause the pustular vasculitis in the bowel-associated dermatosisarthritis syndrome.

(Arch Intern Med 1984;144:738-740)

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