In a 32-year-old woman and a 40-year-old man with
cutaneous vasculitis, etiological allergic responses to foods and airborne
allergens were found. During provocation tests, observations were made on blood levels of
fibrinopeptide A(FPA) and
coagulation factors,
fibrinogen degradation products (
FDP) and serum
complement components. Skin biopsies were taken for microscopic and immunofluorescence analysis. In case 1, anaphylactoid
allergy to milk and reaginic and anaphylactoid
hypersensitivity to grass pollens were found. Dermal provocations with grass pollens gave
arthralgia,
hematomas, serum C3 fluctuation,
factor VII reduction and fibrinolysis. During peroral milk challenge, transient increases in FPA and
FDP levels were observed before symptoms appeared. In case 2, anaphylactoid
hypersensitivity responses to bacteria, animal danders, foods and pollens were found. Two inhalations with sheep-wool extract resulted in a typical skin eruption. The first also gave an early reduction of C3 and then FPA liberation. Nasal birch-pollen test gave an increase of FPA in the latent period and then typical nodules. At least no low molecular weight
FDP were detected during provocations. In patients with
vasculitis reactions to exogenous
allergens, FPA and
FDP estimations after provocations may discriminate harmful from innocuous
allergens and reveal individual response patterns in coagulation and fibrinolysis systems.