Analysis Of Clinical Manifestations And Misdiagnosis Of Henoch-schonlein Purpura With Acute Abdominal Pain In Adults

Objective To investigate the clinical manifestations and misdiagnosis of Henoch-Schonlein Purpura with acute abdominal pain in adults. Methods All 652 adult patients with acute abdominal pain were admitted into First Hospital of Jinlin University with clarified diagnosis and complete information from January, 2009 to March, 2010. All patients were divided into two groups:HSP group and non-HSP group. The epidemiology characterisitics, lab tests, causes of abdominal pain and misdiagnosis are recorded and analysed between the two groups.Results (1) The ratios of HSP group in inducement of respiratory infection and food, onset in winter, male, youth are highier than non-HSP group; and age, the ratios of non-HSP group in no inducement, onset in summer and middle age are highier than HSP group,and the ratio of two groups has significant differences (P<0.05). (2) The level of serum IgA, the ratio of counts with IgA highier than normal level and the ratios of counts with proteinuria positive and hematuria positive in HSP group are higher than non-HSP group, and the results have significant differences(P<0.05). (3) Parts of the causes of acute abdominal pain are HSP (4.75%), acute gastroenteritis (15.03%), acute pancreatitis (8.47%), acute appendicitis (8.59%), acute cholecystitis (7.21%) and intestinal obstruction (5.82%). (4) The ratio of misdianosis of HSP group is highier than non-HSP group, and the result has significant differences (P<0.05).Conclusions (1) For adult patients with acute abdominal pain, HSP is prone to happen on male youth, in winter and with inducements of respiratory infection or protein food ;non-HSP is prone to happen on middle-aged female, in summer ,with no aparrent inducement. (2) For adult patients with acute abdominal pain,HSP is prone to have the level of serum IgA highier than normal level,proteinuria and hematuria. (3) Henoch- Schonlein Purpura wtith acute abdominal pain in adults is relatively common, and the causes of acute abdominal pain are the commonest in turn: acute gastroenteritis, acute pancreatitis, acute appendicitis, acute cholecystitis and intestinal obstruction. (4) The ratio of misdiagnosis of HSP with abdominal pain is high,to which should be paid much attention by the physician of Emergency Department.