INVESTIGATION OF THE LOCAL PROVOCATION TEST TO PPP AND IGA NEPHRITIS

We examined 24 cases with pustulosis palmaris et plantaris (PPP) and 1 3 cases with IgA nephritis. The provocation test was performed in 11 c ases with PPP and 7 cases with IgA nephritis. According to Nosaka's cr iteria, as variables for assessing the provocation test, changes in WB C (white blood cell count), BT (temperature), ESR (erythrocyte sedimen tation rate) and skin eruption or urinary endings (hematuria and prote inuria) were estimated. Analysis of the provocation test proved positi ve in 3 of 11 cases (27%) with PPP and in 5 of 7 cases (71%) with IgA nephritis. Improvement of PPP was found in 12 of 14 cases (86%) with t onsillectomy and in 5 of 10 cases (50%) without tonsillectomy. However , there was no significant relation between prognosis and results of p rovocation tests. Improvement of IgA nephritis was found in 6 of 10 ca ses (60%) with tonsillectomy and none of 3 cases (0%) without tonsille ctomy. Furthermore, the cases with positive reaction by the provocatio n test showed better prognosis than those with negative reaction. Our results suggest that in patients with IgA nephritis, the efficacy of t onsillectomy is better in patients with a positive reaction to the pro vocation test than in those with a negative reaction. However, this ph enomenon was not observed in the patients with PPP. Improvement of sym ptoms in the patients undergoing tonsillectomy was found in the early time period after surgery as compared with that in the patients with c onservative treatment.