CAJ | 학술논문

目的：分析成人以消化系统症状为首发表现的腹型过敏性紫癜（HPS）的误诊原因。方法选取我院15例误诊的成人腹型HPS作为研究对象，进行回顾性分析。结果15例患者均有腹痛，伴恶心3例、呕吐4例、腹泻4例、血便3例、发热1例、关节疼痛3例、肌肉酸痛1例。伴大便潜血阳性6例，WBC升高7例，蛋白尿3例、血尿1例，血清淀粉酶升高1例，CRP升高6例，2例胃肠镜检查均提示黏膜充血水肿，可见糜烂及溃疡。15例患者分别在入院后3~10d出现皮肤紫癜，确诊后糖皮质激素治疗有效。结论腹型HPS临床表现复杂多样，容易误诊，需详细询问病史，动态观察病情变化，辅以内镜检查可提高诊断率。
목적：분석성인이소화계통증상위수발표현적복형과민성자전（HPS）적오진원인。방법선취아원15례오진적성인복형HPS작위연구대상，진행회고성분석。결과15례환자균유복통，반악심3례、구토4례、복사4례、혈편3례、발열1례、관절동통3례、기육산통1례。반대편잠혈양성6례，WBC승고7례，단백뇨3례、혈뇨1례，혈청정분매승고1례，CRP승고6례，2례위장경검사균제시점막충혈수종，가견미란급궤양。15례환자분별재입원후3~10d출현피부자전，학진후당피질격소치료유효。결론복형HPS림상표현복잡다양，용역오진，수상세순문병사，동태관찰병정변화，보이내경검사가제고진단솔。
ObjectiveTo analysis of the reasons for misdiagnosis of adult with asabdominal type Henoch Schonlein purpura (HPS) which first performance of gastrointestinal symptoms. Methods 15 cases misdiagnosed adult HPS patients in our hospital were selected as the object of study, and they were retrospectively analyzed.Results15 patients had abdominal pain, 3 cases with nausea, 4 cases with vomiting, 4 cases with diarrhea, bloody stool in 3 cases, 1 cases of fever, 3 cases of joint pain, 1 cases of muscle soreness. With fecal occult blood positive in 6 cases, 7 cases with elevated WBC, proteinuria in 3 cases, 1 cases of hematuria, 1 cases with elevated serum amylase, CRP elevated in 6 cases, 2 cases of gastrointestinal endoscopy showed mucosal hyperemia and edema, visible erosion and ulcer. 15 patients respectively in skin purpura occured 3-10 days after admission, effective glucocorticoid treatment after diagnosis.ConclusionThe clinical manifestations of HPS in abdominal type is complicated, easy to be misdiagnosed, should ask detailed history, dynamic observe the changes in condition, supplemented by endoscopic examination can improve the diagnosis rate.