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自身红细胞致敏试验在复发性自发性瘀斑诊断中的作用

Role of Autoerythrocyte Sensitization Test in the Diagnosis of Recurrent Spontaneous Bruising.

作者信息

Kumar Praveen, Singh Ajeet, Prabha Neel, Ganguly Satyaki, Dudhe Mayur

机构信息

Department of Dermatology, Venereology and Leprosy, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.

出版信息

Indian Dermatol Online J. 2023 Apr 4;14(3):375-378. doi: 10.4103/idoj.idoj_556_22. eCollection 2023 May-Jun.

Abstract

INTRODUCTION

Psychogenic purpura, also known as autoerythrocyte sensitization syndrome, is a rare condition which is characterized by spontaneous development of painful purpura, or ecchymoses. Skin lesions are usually preceded by stress and emotional trauma. It is usually a diagnosis of exclusion after ruling out history of trauma, drug intake and other bleeding disorders. Autoerythrocyte sensitization test (AEST) and a psychiatric evaluation helps in the diagnosis and treatment.

OBJECTIVE

To demonstrate the importance of AEST in diagnosing the patient of Gardner Diamond syndrome.

MATERIALS AND METHODS

Five suspected cases of autoerythrocyte sensitization syndrome underwent AEST after ruling out other causes of bleeding.

RESULTS

Four out of five patients were positive for AEST while one patient was negative. Psychiatric complaints were present in three patients. One patient was lost to follow up. Rest all patients responded well to vitamin C supplementation.

CONCLUSION

Autoerythrocyte sensitization syndrome is a rare disorder and is a diagnosis of exclusion, so a thorough workup of the patient to rule out common causes of bruising is essential. A high index of suspicion on the clinician's part and a simple OPD-based AEST may help in the diagnosis. Psychiatric consultation is important to find out the stress factor and timely management.

摘要

引言

心理性紫癜,又称自身红细胞致敏综合征,是一种罕见病症,其特征为自发性出现疼痛性紫癜或瘀斑。皮肤病变通常先于压力和情绪创伤出现。在排除创伤史、药物摄入及其他出血性疾病后,通常才能做出诊断。自身红细胞致敏试验(AEST)及精神科评估有助于诊断和治疗。

目的

证明AEST在诊断加德纳·戴蒙德综合征患者中的重要性。

材料与方法

5例疑似自身红细胞致敏综合征患者在排除其他出血原因后接受了AEST检查。

结果

5例患者中有4例AEST呈阳性,1例呈阴性。3例患者有精神方面的主诉。1例患者失访。其余所有患者补充维生素C后反应良好。

结论

自身红细胞致敏综合征是一种罕见疾病,是一种排除性诊断,因此对患者进行全面检查以排除常见的瘀伤原因至关重要。临床医生高度怀疑并进行简单的基于门诊的AEST检查可能有助于诊断。精神科会诊对于找出压力因素并及时进行管理很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc62/10231704/f7dbd8574548/IDOJ-14-375-g001.jpg

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