Vasculite cutânea de pequenos vasos: etiologia, patogênese, classificação e critérios diagnósticos - Parte I / Small vessel cutaneous vasculitis: etiology, pathogenesis, classification and diagnostic criteria - Part I

Vasculite é a inflamação da parede dos vasos. Pode variar em gravidade desde doença autolimitada de um único órgão até doença grave com risco de morte por falência de múltiplos órgãos. Existem várias causas, embora só se apresente por poucos padrões histológicos de inflamação vascular. Vasos de qualquer tipo e em qualquer órgão podem ser afetados, resultando em ampla variedade de sinais e sintomas. Diferentes vasculites com apresentações clínicas indistinguíveis têm evolução e tratamento muito diferentes. Essa condição representa desafio para o médico, incluindo classificação, diagnóstico, exames laboratoriais pertinentes, tratamento e seguimento adequado. Neste artigo são revistos a classificação, a etiologia, a patogênese e os critérios diagnósticos das vasculites cutâneas.

Vasculitis is an inflammation of vessel walls. It may range in severity from a self-limited disorder in one single organ to a life-threatening disease due to multiple-organ failure. It has many causes, although they result in only a few histological patterns of vascular inflammation. Vessels of any type in any organ can be affected, a fact that results in a broad variety of signs and symptoms. Different vasculitides with indistinguishable clinical presentations have very different prognosis and treatments. This condition presents many challenges to physicians in terms of classification, diagnosis, appropriate laboratory workup, treatment, and the need for careful follow-up. This article reviews the classification, etiology, pathology and diagnostic criteria of cutaneous vasculitis.

Evaluation of the VIDAS chlamydia test detect Chlamydia trachomatis in samples from urogenital tract / 中华检验医学杂志

Objectives To evaluate bioMerieux VIDAS(Vitek Immune Diagnositc Assay System) Chlamydia test (CHL) and to determine its performance(sensitivity and specificity) by comparing with cell culture. Methods C. trachomatis in urogenital samples was detected by both cell culture and VIDAS CHL. The different results were confirmed by direct fluorescent antibody assay (DFA). The sensitivity to C.trachomatis serotype D and E stocks was alsode tected with VIDAS CHL and cell culture. Results C.trachomatis was found in 33 (20.2%) of 163 urogenital samples by cell culture in coutrast to in 44(27.0%) by VIDA CHL. As the expanded gold standard was defined as either cell culture positive or cell culture negative and both CHL and DFA positive, the sensitivity was 80.5% and 95.3% and the specifiaty were 100% and 97.6% in cell culture and VIDAS CHL, respectively. In the sensitivity test, C. trachomatis serotype D was tested positive at the highest dilution of one to 102 400 dilution and serotype E was at one in 51 200 by cell culture. However, both serotype D and E were tested positive at the highest dilution of one to 6 553 600 by VIDAS CHL. Conclusions Comparing with the expanded gold standard, VIDAS CHL is sensitive and specific for C.trachomatis in urogenital specimens, with simple and short running hours (1 h). First catch urine (FCU), which avoids the painful male swab collectionin male patients, could also be used as specimen in VIDAS CHL test.