Clinical Manifestations And Misdiagnosis Of Anaphylactoid Purpura Abdominalis In Adults

Objective:To discuss the clinical manifestations and misdiagnosis of Anaphylactoid Purpura Abdominalis in Adults and to get better understanding of the disease.Methods:The patients were admitted into Xiangya hospital as Anaphylactoid Purpura from January of 2002 to December of 2007,All 102 patients were divided into two groups by abdominal symptoms, abdominal group and non-abdominal group,patients' onset inducement,first clinical manifestation,general symptom and laboratory findings were recorded and analyzed by statistical soft to see if they had statistical difference between two groups.Retrospective analysis was conducted upon clinical manifestations and results of misdiagnosis in patients with Anaphylactoid Purpura Abdominalis.Results:The cases of Anaphylactoid Purpura ranged from 16 to 72 years old and had a peak onset age of 16-20,with a male-to-female ratio of 2.09:1,32.4%patients had history of upper respiratory tract infections, 65.7%patients' onset seasons was in winter and spring.There was no statistical difference in onset season,upper respiratory infection,onset age,arthralgia and renal involvement,hematuria,proteinuria,elevation of IgA,descent of IgG and C3 between two groups,Patients with abdominal symptoms had higher white blood cell counts,higher serum C-reactive protein levels,and lower albumin levels than those without.Main clinical symptoms in Patients with abdominal symptoms included skin rash(100%),abdominal pain(100%),gastrointestinal hemorrhage(72.7%),vomit(37.9%)and diarrhea(34.8%),Endoscopy demonstrated the damages to the mucosa fluctuated from congestion,edema,petechia to erosive and multiple ulcers,could combine together, the lesions were predominant in the duodenum and the terminal ileum.Patients with Anaphylactoid Purpura Abdominalis especially those with abdominal pain as the first clinical manifestation,were easy to mistake for acute abdomen.Conclusions:â‘ The prevalence of Anaphylactoid Purpura is in winter and spring and the major inducement is upper respiratory infection,it occurs commonly in male and at the youth.â‘¡The abdominal-group Patients have higher white blood cell counts,higher serum C-reactive protein levels,and lower albumin levels than the non-abdominal group.â‘¢Gastrointestinal symptoms are serious, howerer,the gastrointestinal signs are relatively minor in patients with Anaphylactoid Purpura Abdominalis.The lesions of Endoscopy are predominant in the duodenum and the terminal ileum.â‘£Patients with Anaphylactoid Purpura Abdominalis especially those with abdominal pain as the first clinical manifestation have a high risk of misdiagnosis.