成人腹型过敏性紫癜误诊原因分析

Misdiagnosed Causes of Abdominal-type Henoch-schonlein Purpura in Adults

目的分析成人腹型过敏性紫癜的误诊原因,并总结防范误诊措施。方法回顾分析2011年7月1日—2021年7月1日3例被误诊成人腹型过敏性紫癜的临床资料。结果本组误诊率为14.3%。3例均以腹痛为首发症状就诊,早期均无皮肤紫癜症状。1例误诊为消化性溃疡伴出血、胆囊炎,1例误诊为胃炎、胆囊炎,1例误诊为胃肠功能紊乱、盆腔炎。3例均在后期出现皮肤紫癜症状,明确诊断,给予糖皮质激素治疗后病情好转。结论成人腹型过敏性紫癜临床少见,消化道症状常为首发症状,容易误诊,临床医生应提高警惕,避免误诊误治。

Objective To analyze misdiagnosed causes of abdominal-type henoch-schonlein purpura(HSP)in adults and to summarize the measures to prevent misdiagnosis.Methods Clinical data of 3 misdiagnosed patients with abdominal-type HSP from July 1,2011 to July 1,2021 was retrospectively analyzed.Results The misdiagnosed rate in this group was 14.3%.Abdominal pain was the initial symptom in the 3 patients,and no skin purpura symptom was found in the early stage.One patient was misdiagnosed as having peptic ulcer complicated by hemorrhage and cholecystitis;one was misdiagnosed as having gastritis and cholecystitis,and one as having gastrointestinal dysfunction and pelvic inflammatory disease.The symptoms of skin purpura occurred in all the 3 patients in the later stage,and then the diagnosis was confirmed.Patients'conditions were improved after glucocorticoid treatment Conclusion Abdominal-type HSP in adults is rare in clinical practice,and gastrointestinal symptoms are generally initial symptoms.Therefore,it is more likely to be misdiagnosed.Clinicians should be vigilant to avoid misdiagnosis and mistreatment.