RESUMO
BACKGROUND: Dermatitis herpetiformis (DH) is a very rare bullous dermatitis of autoimmune origin. It is a syndrome involving dermal and intestinal pathology, in which vesicopapular skin lesions are accompanied by gluten-dependent enteropathy. The diagnosis of DH is based on immunopathological investigation of unaffected skin bioptate (presence of granular IgA deposits in the upper portions of dermal papillae). MATERIAL/METHODS: The study was carried out in a group of 33 patients, including 23 males and 10 females aged 22-78 (mean age 44.7 years). The following fibrinolysis system parameters were determined in the sera of all patients: tissue plasminogen activator concentration (t-PA: Ag), urokinase plasminogen activator concentration (u-PA: Ag), plasminogen activator inhibitor concentration (PAI-Ag), plasminogen level, alpha-2 antiplasmin activity (alpha-2-AP), plasmin-- alpha-2 antiplasmin complexes concentration (PAP). RESULTS: Mean t-PA concentration in DH patients was 5.52 ng/ml, vs. 4.8 ng/ml in controls. The respective u-PA concentrations amounted to 0.33 ng/ml, and 0.39 ng/ml. PAI-1 concentration was markedly higher in DH patients (36.2 ng/ml) than in controls (22.40 ng/ml), whereas plasminogen level was significantly lower (86.0% vs. 115.9%). In patients, alpha-2-AP activity was 92% and was lower than in controls -103.4%. DH patients demonstrated also higher concentrations of PAP complexes (327.45 ng/ml) than the control group (203.03 ng/ml). CONCLUSIONS: Patients with DH were found to have lower plasminogen and alpha-2 antiplasmin levels and increased concentrations of PAP complexes, which indicates increased plasminogenesis in vivo. Increased type 1 plasminogen activator inhibitor level (PAI-1) may reflect a chronic inflammatory condition present in DH patients.
