| Background and objective:Henoch-Sch?nlein purpura (HSP) is the most common systemic vasculitis in children which is characterized by small vessel leucocytoclastic vasculitis. It usually affects children between the ages of 3 and 15 years. The etiology remains unknown, although many antigens, such as infective agents, vaccinations, drugs, foods, and insect bites have been found to trigger HSP. The disease is characterized by the deposition of immunoglobulin A (IgA) containing immune complexes (IC) and complement components within small vessel walls, often within the renal mesangium. The main clinical manifestations of HSP are non-thrombocytopenic palpable purpura, arthritis, arthralgias, renal involvement, gastrointestinal manifestations and edema. Uncommon clinical features include orchitis, pneumonia, headache, seizures, and so on. The main laboratory data of the acute phase are elevated ESR, increased serum IgA levels, proteinuria, hematuria, low C3 and/or C4 serum levels, positive fecal occult blood tests. Platelet count is normal. Laboratory tests usually help in excluding other diagnoses and in evaluating renal function, but are not diagnostic for HSP. HSP is classically a benign and self limited disease that requires only supportive care. The use of corticosteroids as a therapeutic intervention for various manifestations of HSP is recommended by some authors recently.HSP is typically a clinical diagnosis. Diagnostic confirmation requires immunofluorescent detection of microscopic IgA deposits in the vascular walls of the skin or kidney tissue. But sometimes, it is difficult to make a correct diagnosis at first time especially facing the patient with gastrointestinal manifestations. Although there were a lot of studies about the misdiagnosis of HSP, most of them have been limited to hospital-based or regional-based sampling data. So we use CNKI searching the literatures about the misdiagnosis of HSP and analyzing every literature in the purpose to clarify the misdiagnosis of HSP.Method1 We search literatures in CNKI database using"Henoch-Sch?nlein purpura"as keyword, then in the result using"diagnostic errors"as keyword.2 We choice the literatures mating the requesting of our study by reading the 64 literatures collected from CNKI one by one. Then we record the information asked for our analysis. Finally there are 35 in 64 literatures involved in our study.3 We analyze the information from these literatures and make a conclusion.Results1 The misdiagnosis rate of HSP is 11.77%. Especially in the patient with gastrointestinal manifestations, the misdiagnosis rate is as high as 53.6%. The duration time of misdiagnosis is from 15 hours to 6 months.2 The rate of surgery in these patients is 7.6%.3 The five diseases most commonly misdiagnosed for HSP patients at first time:①acute appendicitis;②acute nephritis;③rheumatic arthritis;④intussusception;⑤acute peritonitis.4 Epidemiological data of misdiagnosis patients in our study:①male:female=1.86:1.②45% of misdiagnosis patients involved in our study has a inducing factor.③Only one literature in our study reports that the rate of recurrence in HSP misdiagnosis patients is 20.83%.Conclusions1 The misdiagnosis rate of HSP is high, especially in the patient with gastrointestinal manifestations.2 The rate of surgery is high, once misdiagnosed.3 When you diagnose your patient with follow five diseases, you should exclude HSP:①acute appendicitis;②acute nephritis;③rheumatic arthritis;④intussusception;⑤acute peritonitis.4 Epidemiological data in our study is similar to other studies in other countries or regions, but the male seem to more easily be misdiagnosed.
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