From Big Medical Encyclopedia

SUBSEPSIS ALLERGIC (Latin the sub-prefix under + sepsis; synonym Vissler's disease — Fankoni) — the disease of the infectious and allergic nature which is characterized by high fever, polymorphic rash, an arthralgia and a neutrophylic leukocytosis. It is described in 1944 by H. Wissler, and 2 years later — G. Fankoni.

Etiology Page and. remains not clear. Most of researchers consider what a releaser of development of a disease is acute or hron. infection. However it is not possible to sow the activator from blood of patients. It is established that in an active phase of a disease there are considerable changes of humoral immunity in the form of the increased maintenance of IgM and IgG (see Immunoglobulins), and also decrease complement (see). In some cases at patients the antinuclear factor comes to light and cell-bound immune complexes in cells of epidermis are found. It formed the basis to carry S. and. to the diseases proceeding with the expressed immunopathology.

Patol. anatomy Page and. it is a little studied. Basic morfol. a sign is diffusion vasculitis (see) preferential microcirculator-nogo of a bed.

Beginning of a disease, as a rule, acute. It is noted high alternating or remittiruyushchy fever (see). The peak of fever in most cases falls on morning hours, is followed by plentiful skin rashes, joint pains (see. Arthralgia ) and muscles (see. Mialgiya ). Rash polymorphic (urtikarny, spotty and papular, punctulate). Quite often rise in temperature is preceded by a fever. In 3 — 5 hours temperature decreases that is followed by plentiful sweating, rash turns pale, pains pass, the health of patients considerably improves. The next morning everything repeats. Increase limf, nodes, a liver, spleens, sometimes polyarthritis is noted. In hard cases can develop pleurisy (see), a pericardis (see), a polyserositis (see), myocarditis (see), a pneumonitis (see).

S.'s current and. happens mono - and on-litsiklichnym. At a monocycling current acute displays of a disease abate later 2 — 4 weeks; longer the accelerated ROE and raised immunol remains. indicators. A recurrence does not happen. The polycycling current of S. is more often observed and. lasting up to 4 — 5 years with a frequency of recurrence of 1 — 3 time a year; at such current of S. and. accession of a polyserositis, myocarditis, pneumonitis is characteristic.

Diagnosis put a wedge, pictures, a lab on the basis. yielded, results rentgenol. researches. At rentgenol. a research find inching of transparency of pulmonary fields at the expense of a capillaritis, strengthening of the intersticial drawing, gentle pleural imposings. In blood the high neutrophylic leukocytosis (more than 20 000) with the expressed band shift (to 20%), sharply accelerated ROE, increase in IgM and IgG is noted.

Differential diagnosis carry out with diffusion diseases of connecting fabric (see. Collagenic diseases ) and especially juvenile pseudorheumatism (see the Pseudorheumatism). At early stages of S. and. it is difficult to distinguish from the last therefore it is necessary morfol. research of a synovial membrane of a joint. Further at S. and., unlike a juvenile pseudorheumatism, permanent changes in joints does not form even at the recurrent course of process.

Treatment Page and. shall be complex. The combination of corticosteroid drugs, antibacterial agents, and also derivatives of quinoline is the most effective, In mild cases appoint only derivatives of quinoline and antibacterial agents. At a heavy current of S. and. apply also cytostatics. During the subsiding of process pass to a maintenance therapy. At absence within half a year of a recurrence of a disease treatment can be completely cancelled.

Forecast at S. and. in overwhelming: most cases favorable.

Bibliography: Balaban V. G. and In ft-those N to about V. P. Allergic subsepsis of Vissler — Fankoni, Vopr. okhr. mat. also it is put., t. 10, No. I, page 52, 1965; Brothers of B of river. C. Subsepsis allergica at children's age, in book: Sovr. probl. fiziol. and patol. detsk. age, under the editorship of Yu. F. Dombrovskaya, page 260, M., 1965; Hamburg R. D. K to differential diagnosis between rheumatism and allergic subsepsis (Vissler's disease — Fankoni), in book: Vopr. serd. - vascular patol., under the editorship of. And. 3. Chernova, page 170, M., 1963; Of Zaytsevo. And. and With and in e l the island and E. M. About allergic subsepsis of Vissler, Pediatrics, No. 5, page 28, 1962; Shaganb. T. and Afanasenko I. P. Allergic subsepsis of Vissler — Fankoni and collagenic diseases * Vopr. okhr. mat. also it is put., t. 16, No. 11 * page 88, 1971; Yakovleva A. A. and P Osh and l N. I. About Vissler's syndrome — Fankoni and his bonds with infectious nonspecific (rhematoid) polyarthritis, Owls. medical, No. 2, page 79, 1964; Knopf D., Sonnichsen N. u. In and of t h e 1 m e s H. Kasuistisclier Beit-rag zur Subsepsis allergica Wissler unter besonderer Beriicksichtigung immunologis-cher Untersuuhungen, Derm. Mschr. Bd 157, S. 917, 1971; M o e lier M. u. M ii 1 - 1 e r K. D. Subsepsis allergica W issler im Erwachsenenalter, Eiu klinischer und pathologisch-anatomischer Beitrag, Dtsch. med. Wschr., S. 1553, 1972; W i s s 1 e r H. t } ber eine besondere Form sepsisalmlirlur Krankheiten (Subsepsis hyperergica), Mscbr. Kinderheilk., Bd 94, S. i, 1944.

L. A. Isaeva, And. E. Shakhbazyan.