Volume 23 Issue 7
Jul.  2025
Turn off MathJax
Article Contents
LUO Limian, LI Qi, XIE Miao. A case of misdiagnosis of adult abdominal anaphylactoid purpura and literature review[J]. Chinese Journal of General Practice, 2025, 23(7): 1262-1266. doi: 10.16766/j.cnki.issn.1674-4152.004111
Citation: LUO Limian, LI Qi, XIE Miao. A case of misdiagnosis of adult abdominal anaphylactoid purpura and literature review[J]. Chinese Journal of General Practice, 2025, 23(7): 1262-1266. doi: 10.16766/j.cnki.issn.1674-4152.004111

A case of misdiagnosis of adult abdominal anaphylactoid purpura and literature review

doi: 10.16766/j.cnki.issn.1674-4152.004111
  • Received Date: 2024-01-16
    Available Online: 2025-10-25
  • This study investigates the instance of misdiagnosis in adult cases of abdominal purpura, elucidating the causative factors, correlating them with existing clinical literature while compiling the diagnostic characteristics of abdominal purpura in an effort to diminish the rate of misdiagnosis. A retrospective analysis was conducted on the medical records of a patient who was initially misdiagnosed with acute gastroenteritis in July 2020.the patient presented with skin purpura after abdominal pain. Following a multidisciplinary review, the patient was ultimately identified as suffering from abdominal purpura, and was discharged after receiving symptomatic treatment with glucocorticoids and anti-allergic drugs. The study concluded that abdominal purpura is a rare condition, especially among adults, and that its non-specific clinical manifestations, in conjunction with the absence of definitive ancillary examinations contribute to a high misdiagnosis rate. It is recommended that clinical workers learn from this case to avoid misdiagnosis and mistreatment.

     

  • loading
  • [1]
    SONG Y, HUANG X H, YU G Z, et al. Pathogenesis of IgA vasculitis: an up-to-date review[J]. Front Immunol, 2021, 12(12): 771619. DOI: 10.3389/fimmu.2021.771619.
    [2]
    XU L Y, LI Y Z, WU X. IgA vasculitis update: epidemiology, pathogenesis, and biomarkers[J]. Front Immunol, 2022, 13(13): 921864. DOI: 10.3389/fimmu.2022.921864.
    [3]
    BAI L P, YU J, SUN Y X C, et al. Efficacy of montelukast for the treatment of pediatric allergic purpura[J]. Medicine(Baltimore), 2019, 98(39): e17239. DOI: 10.1097/MD.0000000000017239.
    [4]
    PILLEBOUT E, SUNDERKOTTER C. IgA vasculitis[J]. Semin Immunopathol, 2021, 43(5): 729-738. doi: 10.1007/s00281-021-00874-9
    [5]
    MCPARTLAND K, WRIGHT G. Acute abdominal pain: henochschonlein purpura case in a young adult, a rare but important diagnosis[J]. Clin Med, 2019, 19(1): 77-79.
    [6]
    BUSCATTI I M, SIMON J R, VIANA V, et al. Intermittent abdominal pain in IgA vasculitis[J]. Rev Paul Pediatr, 2021, 40(1): e2020202. DOI: 10.1590/1984-0462/2022/40/2020202.
    [7]
    LIU Y J, ZENG H J, WANG B, et al. Intra-abdominal hemorrhage with shock in an adult with IgA vasculitis[J]. Asian J Surg, 2023, 46(4): 1898-1899. doi: 10.1016/j.asjsur.2022.10.090
    [8]
    瞿治明, 刘刚, 邬经纬, 等. 成人腹型过敏性紫癜误诊1例并原因总结分析[J]. 医学理论与实践, 2023, 36(23): 4135-4137.

    QU Z M, LIU G, WU J W, et al. Summary and analysis of misdiagnosis of adult abdominal anaphylactoid purpura: a case report[J]. The Journal of Medical Theory and Practice, 2023, 36(23): 4135-4137.
    [9]
    REAMY B V, SERVEY J T, WILLIAMS P M. Henoch-Schönlein purpura (IgA vasculitis): rapid evidence review[J]. Am Fam Physician, 2020, 102(4): 229-233.
    [10]
    任瑞华, 罗沙沙, 钟小明. 过敏性紫癜发病机制的研究进展[J]. 赣南医学院学报, 2023, 43(10): 1080-1083, 1096.

    REN R H, LUO S S, ZHONG X M. Advances in Research on Pathogenesis of Allergic Purpura[J]. Chinese Journal of Dermatovenereology of Integrated Traditional and Western Medicine, 2023, 43(10): 1080-1083, 1096.
    [11]
    CATAL O, OZER B, SIT M. Henoch-Schönlein purpura presenting with acute abdomen[J]. J Coll Physicians Surg Pak, 2021, 31(3): 350-352. doi: 10.29271/jcpsp.2021.03.350
    [12]
    朱亮, 宋丰前, 邝国兵, 等. 1例成人腹型过敏性紫癜病例报告[J]. 中国社区医师, 2023, 39(1): 48-50.

    ZHU L, SONG F Q, KUANG G B, et al. A case report of adult abdominal henoch-schonlein purpura[J]. Chinese Community Doctors, 2023, 39(1): 48-50.
    [13]
    HAN Y, JIN S Y, KIM D W, et al. Endoscopic and microscopic findings of gastrointestinal tract in Henoch-Schönlein purpura: single institute experience with review of literature[J]. Medicine(Baltimore), 2019, 98(20): e15643. DOI: 10.1097/MD.0000000000015643.
    [14]
    丘岳, 张宏亮, 黄振光, 等. 肿瘤化疗致胃肠不适或恶心呕吐的预防用药临床指南系统评价[J]. 医药导报, 2018, 37(12): 1518-1523.

    QIU Y, ZHANG H L, HUANG Z G, et al. Systematic review of clinical guidelines for prevention of cancer chemotherapy-induced gastrointestinal adverse reactions[J]. Herald of Medicine, 2018, 37(12): 1518-1523.
    [15]
    周林, 张绍金, 黄英, 等. 成人腹型过敏性紫癜1例并文献复习[J]. 中国临床医学影像杂志, 2022, 33(1): 66-68.

    ZHOU L, ZHANG S J, HUANG Y, et al. Abdominal anaphylactoid purpura in adult: report of one case and literature review[J]. Journal of China Clinic Medical Imaging, 2022, 33(1): 66-68.
    [16]
    石浩, 段雅雅, 卜欣婷. 4例腹型过敏性紫癜误诊为急腹症患者的临床分析[J]. 中国社区医师, 2023, 39(22): 43-44, 47.

    SHI H, DUAN Y Y, BU X T. Clinical analysis of four cases with abdominal allergic purpura misdiagnosed as acute abdomen[J]. Chinese Community Doctors, 2023, 39(22): 43-44, 47.
    [17]
    SEQUEIRA C, SANTOS I, OLIVEIRA A P. Henoch-Schönlein purpura masquerading as Crohn ' s disease flare[J]. Rev Esp Enferm Dig, 2023, 115(10): 581. DOI: 10.17235/reed.2022.9414/2022.
    [18]
    SHIMOYAMA T, MATSUDA N, KUROBE M, et al. Colonoscopic diagnosis and reduction of recurrent intussusception owing to Henoch-Schönlein purpura without purpura[J]. Paediatr Int Child Health, 2019, 39(3): 219-223. doi: 10.1080/20469047.2018.1457273
    [19]
    张海华, 袁伟建. 成人腹型过敏性紫癜的临床特征及误诊分析[J]. 中国内镜杂志, 2012, 18(12): 1260-1263.

    ZHANG H H, YUAN W J. Clinical manifestations and misdiagnosis of anaphylactoid purpura abdominalis in adults[J]. China Journal of Endoscopy, 2012, 18(12): 1260-1263.
    [20]
    KANEKO K, FUJⅡ S. Diagnostic value of plasma factor ⅩⅢ in Henoch-Schönlein purpura[J]. Pediatr Nephrol, 2004, 19(6): 702-703. doi: 10.1007/s00467-004-1468-2
    [21]
    刘娜娜, 丁周志, 陈琼, 等. 过敏性紫癜患儿总IgE、IgA及补体C3水平对疾病预后的预测价值[J]. 中华全科医学, 2019, 17(9): 1463-1466. doi: 10.16766/j.cnki.issn.1674-4152.000970

    LIU N N, DIN Z Z, CHEN Q, et al. The predictive value of total IgE, IgA and complement C3 for prognosis in children with Henoch-Schonleinpurpura[J]. Chinese Journal of General Practice, 2019, 17(9): 1463-1466. doi: 10.16766/j.cnki.issn.1674-4152.000970
    [22]
    钟华杰. D-二聚体、LTB4、IL-23在急性期过敏性紫癜患儿外周血的水平表达及意义[J]. 中华全科医学, 2017, 15(6): 968-970. doi: 10.16766/j.cnki.issn.1674-4152.2017.06.018

    ZHONG H J. Expression and significance of D-two polymer, LTB4 and IL-23 in peripheral blood of children with Henoch Schonlein purpura[J]. Chinese Journal of General Practice, 2017, 15(6): 968-970. doi: 10.16766/j.cnki.issn.1674-4152.2017.06.018
    [23]
    HORI H, FUKUCHI T. "Comb and Target signs" in abdominal CT in patients with purpura[J]. Eur J Intern Med, 2022, 95: 93-94. doi: 10.1016/j.ejim.2021.10.011
    [24]
    GE Y R, LIU S C. Ultrasound, X-ray, computed tomography and clinical tests for diagnosis of abdominal purpura in children: a retrospective study[J]. Exp Ther Med, 2020, 19(6): 3559-3564.
    [25]
    CUI X H, LIU H, FU L, et al. Henoch -Schönlein purpura with intussusception and hematochezia in an adult: a case report[J]. Medicine, 2019, 98(36): e16981-e16984. doi: 10.1097/MD.0000000000016981
    [26]
    王桐. 腹部彩超联合胃镜早期诊断腹型过敏性紫癜的临床应用分析[J]. 中国医疗器械信息, 2021, 27(21): 64-66.

    WANG T. Analysis of clinical application of abdominal color doppler ultrasonography combined with gastroscopy for early diagnosis of abdominal hypersensitivity[J]. China Medical Device Information, 2021, 27(21): 64-66.
    [27]
    孙传涛, 童强, 杨帆, 等. 结肠镜检查早期诊断腹型过敏性紫癜1例并文献复习[J]. 临床消化病杂志, 2020, 32(2): 122-123.

    SUN C T, TON Q, YANG F, et al. Early diagnosis of abdominal anaphylactoid purpura by colonoscopy: a case report and literature review[J]. Chinese Journal of Clinical Gastroenterology, 2020, 32(2): 122-123.
    [28]
    YI F F, BAI Z H, LI Y Y, et al. A good response to glucocorticoid for Henoch -Schönlein purpura with abdominal pain and gastrointestinal bleeding in an adult: a case report[J]. Medicine(Baltimore), 2020, 99(1): e18602-e18607.
    [29]
    张斌. 小儿腹型过敏性紫癜的高频超声诊断价值探讨[J]. 中国卫生标准管理, 2018, 9(9): 124-125.

    ZHANG B. Value of High-frequency Ultrasound in Diagnosis of Abdominal Henoch-schonlein Purpura In Children[J]. China Health Standard Management, 2018, 9(9): 124-125.
    [30]
    罗亚辉, 廖志雄. 丙种球蛋白冲击治疗儿童腹型过敏性紫癜的临床疗效[J]. 儿科药学杂志, 2018, 24(7): 25-28.

    LUO Y H, LIAO Z X. Gamma Globulin of Pulse Therapy for Children with Henoch-Sch(o)nlein Purpura[J]. Journal of Pediatric Pharmacy, 2018, 24(7): 25-28.
    [31]
    耿献辉, 边绪强, 王雪莲, 等. 以消化道症状首发的系统性红斑狼疮误诊原因探析[J]. 临床误诊误治, 2024, 37(4): 1-5.

    GENG X H, BIAN X Q, WANG X L, et al. Exploration of causes of misdiagnosis of systemic lupus erythematosus with gastrointestinal symptoms as the initial manifestation[J]. Clinical Misdiagnosis & Mistherapy, 2024, 37(4): 1-5.
    [32]
    耿献辉, 边绪强, 张洋洋, 等. 成人腹型过敏性紫癜误诊原因分析[J]. 临床误诊误治, 2022, 35(6): 9-12.

    GENG X H, BIAN X Q, ZHANG Y Y, et al. Misdiagnosed causes of abdominal-type Henoch-schonlein purpura in adults[J]. Clinical Misdiagnosis & Mistherapy, 2022, 35(6): 9-12.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(5)

    Article Metrics

    Article views (15) PDF downloads(0) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return