聚乙二醇电解质散诱发腹型过敏性紫癜

Abdominal type Henoch-Schonlein purpura caused by Polyethylene Glycol-Electrolyte Powder

1例54岁男性患者，为明确腹痛腹泻病因拟行电子肠镜检查，给予肠道准备剂聚乙二醇电解质散A剂、B剂各2袋，溶于300 ml温水口服，每20分钟服用1次，共服用4次。2小时后双下肢出现散在暗红色瘀点，直径约0.5 cm，部分融合成瘀斑，境界清楚，压之不褪色，并出现腹部阵发性绞痛，疼痛部位不固定。急查大便常规、尿常规和肾功能，均正常。肠镜检查显示：结肠黏膜广泛水肿，散在点片状黏膜充血，以降结肠以下为著。考虑为腹型过敏性紫癜，可能与聚乙二醇电解质散有关，经糖皮质激素治疗以及对症处理，15天后腹痛消失，瘀斑色淡。

In order to identify the cause for abdominal pain and diarrhea by electronic colonoscopy, one male patient aged 54-year-old took orally polyethylene glycol-electrolyte powder including two bags of agents A and B respectively which were dissolved in 300 ml warm water, and taken 1 time every 20 minutes, for 4 times. Two hours later, many dark red spots with a diameter of 0.5 cm were scattered on both lower limbs which were partly fused into ecchymosis, with clear boundary and not faded after pressing. Meanwhile the patient developed abdominal paroxysmal colic and the pain site was not fixed. The stool, urine routine and kidney function were urgently examined, and their results were normal. The results of colonoscopy showed that the colonic mucosa was widely edematous and there were scattered spotty and patchy mucosal hyperemia, which were remarkable at descending colon and lower segment. It was considered to be abdominal type Henoch-Schonlein purpura which might be related with polyethylene glycol-electrolyte powder. After glucocorticoid and symptomatic treatment, the abdominal pain disappeared and ecchymosis subsided within 15 days.