The clinic manifestations and endoscopic characteristics of abdominal type allergic purpura in adult patients / 中华消化内镜杂志

ABSTRACT

[Abstract] Objective To evaluate the clinical and endoscopic manifestations of abdominal type allergic purpura in adult patients as the evidences in reaching early diagnosis. Methods The clinical and endoscopic manifestations of 32 patients with abdominal type allergic purpura were analyzed retrospectively. Re-SllltS All the patients complained of paroxysmal abdominal colic, 59. 4% patients complained of nausea and vomiting, 50% patients had hematochezia and haematemesis, the occult blood test was positive in all patients, and 25% patients had elevated level of amylase in the blood and urine. Purpura was found in 2-10 days after the presentation of abdominal pain. Endoscopy found hyperaemia, edema, bleeding spots, erosion and ulcer in gastroenterologic mucosa. Duodenal, ileum and caecum had more severe mucous lesions, but the esophageal mucosas in all patients were normal. The clinic and endoscopic misdiagnosis rates were 87.5% and 85.7% respectively. Glucocorticoids were the especially effective medicine in its treatment, while those agents for relieving spasm or antacids were ineffective. Conclusion Many scattered bleeding spots and snow flower-like ulcers on the gastrointestinal mucosa are the most important findings in adult abdominal type allergic purpura patients. Clinic manifestations of these patients are very severe abdominal colic in indefinite sites and merely with mild abdominal objective signs is the important characteristic feature.