摘要
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.
作者
耿献辉
边绪强
张洋洋
王智锋
常书振
冯海龙
吕宁
王子阳
黄锦
GENG Xian-hui;BIAN Xu-qiang;ZHANG Yang-yang;WANG Zhi-feng;CHANG Shu-zhen;FENG Hai-long;LYU Ning;WANG Zi-yang;HUANG Jin(Department of Gastroenterology,the 988th Hospital of PLA Joint Logistics Support Forces,Zhengzhou 450042,China)
出处
《临床误诊误治》
CAS
2022年第6期9-12,共4页
Clinical Misdiagnosis & Mistherapy
基金
河南省医学科技攻关计划科研项目(LHGJ20190881)。
关键词
紫癜
过敏性
成年人
误诊
消化性溃疡出血
胆囊炎
Purpura,schoenlein-henoch
Adult
Misdiagnosis
Peptic ulcer hemorrhage
Cholecystitis