肾紫癜误诊11例报告

Report of 11 Cases with Misdiagnosis of Renal Purpura

目的探讨肾紫癜误诊原因,提高肾紫癜诊治水平。方法回顾性分析1973年6月～2005年3月间肾紫癜误诊11例临床资料。结果11例患者术前全部误诊,其中6例行肾切除术,3例经肾穿刺活检,2例经后腹腔镜探查并活检。所有病例均经病理检查证实为肾紫癜。结论肾紫癜较为少见,其临床表现不典型,极易误诊,临床医师应予高度重视。对疑似病例可行肾穿刺活检或后腹腔腹腔镜探查并活检可减少肾的切除。

Objective To investigate the causes for misdiagnosis of renal purpura and to improve the diagnosis and treatment of this disease, Methods Retrospective analysis of the clinical data of 11 misdiagnosed patients with renal purpura from June 1973 to March 2005. Results Out of the 11 cases misdiagnosed before surgery, 6 cases underwent nephreetomy, 3 cases underwent invasive percutaneous renal biopsy , 2 cases underwent posterior laparoscopy as well as renal biopsy. All eases were diagnosed as renal purpura by histopathological examination. Conclusions Renal purpura is not common. The clinical manifestations are not typical, resulting in the tendency of misdiagnosis. Close attention of clinical physicians is demanded. Conclusion Regarding suspecious eases, pereutaneous renal biopsy or laparoscopy biopsy should be recommended to reduce nephrectomy.