Autoerythrocyte sensitization in Child
The disorder is characterized by bruising without clear precipitating causes or definite trauma. The painful bruises vary in size and may have peculiar or geometric shapes. Associated symptoms include abdominal pain, nausea, vomiting, diarrhea, and headache. Prodromal symptoms such as pain, warmth, or itching at the site prior to the bruising have been described. The bruises resolve in approximately 2 weeks but recur.
Autoerythrocyte sensitization has been associated with psychiatric illness, sometimes subtle and without initial obvious symptoms. Onset may occur following a traumatic event or in the context of severe psychosocial stress. Associated psychiatric abnormalities include depression and anxiety, borderline personality disorder, and obsessive-compulsive disorder.
D69.2 – Other nonthrombocytopenic purpura
275446004 – Gardner-Diamond syndrome
- Traumatic purpura – Bruises can be explained by a known physical force.
- Drug-induced purpura – NSAIDs, clopidogrel, heparin, warfarin, or steroid atrophy.
- Hepatic insufficiency with poor synthetic function
- Vitamin K deficiency – Malabsorption, poor diet, or drugs that bind the vitamin (eg, cholestyramine).
- Disseminated intravascular coagulation
- Consider possibility of domestic violence; the differential diagnosis in children aged 9-12 years old has included child abuse.
- Pigmented purpura (see capillaritis) – Yellow-brown patches with superimposed petechiae.
- Hypergammaglobulinemic purpura of Waldenstrom – Recurrent purpura preceded by mild itching, tingling or burning, often associated with tight fitting clothing, heat, or prolonged standing; associated with polyclonal hypergammaglobulinemia of IgG or IgA rheumatoid factor; Sjögren's syndrome may develop in some patients.
- Clotting or platelet disorders – Personal and/or family history may be suggestive.
- Leukemia – Abnormal CBC or peripheral smear.
- Vasculitis or cryoglobulinemia – Palpable purpura.
- Scurvy / vitamin C deficiency – Dietary history; perifollicular.
- Ehlers-Danlos syndrome, or connective disuse diseases – Skin hyperextensibility; joint hypermobility; joint dislocations / atrophic scars.
- Acute meningococcemia
- Bacterial sepsis
- Systemic amyloidosis