Clinical Analysis of Purpura Due to Raised Intravascular Pressure Misdiag-nosed as Henoch-Schönlein Purpura

SONG Yuchen; ZHAO Wenwen; HU Yan

doi:10.3969/j.issn.1002-3429.2024.15.001

Abstract：Objective To investigate the causes,differentiation points and preventive measures of misdiagnosis of purpura due to raised intravascular pressure as Henoch-Schönlein purpura(HSP)in children.Methods The clinical data of 38 children with purpura due to raised intravascular pressure who were misdiagnosed with HSP from March 2023 to March 2024 were retrospectively analyzed.Results All 38 children presented with different degrees of needle sized rashes on both lower limbs,feet,and ankles during initial diagnosis,scattered or densely distributed,which did not exceed the skin surface nor fade when pressed.In 8 children,rashes were also found on the head and face,both upper limbs and trunk.The previous diagnosis was HSP,but no significant relief was found after corresponding treatment.The patient's medical history was inquired in detail,and the shape and distribution characteristics of the rash were observed.After completing laboratory examination to ex-clude other diseases of the blood system and immune system,the diagnosis of purpura due to raised intravascular pressure was made,and the drug was discontinued for observation and followed up for 24 weeks.The rashes recurred in 27 of 38 patients and resolved spontaneously without medical intervention.Misdiagnosis lasted 2-28 w.No kidney damage was found in all patients.Conclusion The clinical manifestations of purpura due to raised intravascular pressure are not typical,and there is no specific examination index,which often leads to misdiagnosis.Clinical inquiry about medical history and differential diagnosis of rash morphology should be strengthened,and relevant examinations should be performed in time to reduce misdiagnosis.