Autoerthrocyte sensitization---a psychogenic purpura?
There are two schools of thought regarding the pathogenesis of this syndrome. Gardner and Diamond and others demonstrated that these patients have a hypersensitivity to extravasated RBCs. They assumed that a fixed tissue antibody reacted with red blood cell stroma producing edema, increased capillary permeability, and further extravasation of blood into the tissues. Ratnoff, Agle, and others, however, believe the syndrome is a psychiatric disorder and that the ecchymotic lesions represent a form of conversion reaction--a mechanism that could explain the patient's myriad complaints. There is evidence that vascular beds are controlled by psychic processes. Neurogenically elaborated kinin-like agents might serve as humoral mediators between the central nervous system and the local tissue reaction.2,4,12 Regardless of the basic etiology, we think the syndrome is more common than has previously been considered and should be thought of in patients with recurrent purpuric eruptions of the extremities.
D000328:Adult; D001327:Autoimmune Diseases / Q000209:etiology / Q000276:immunology*; D004912:Erythrocytes / Q000276:immunology*; D005260:Female; D006677:Histrionic Personality Disorder / Q000175:diagnosis; D006801:Humans; D011247:Pregnancy; D011602:Psychophysiologic Disorders / Q000175:diagnosis; D011644:Puerperal Disorders / Q000175:diagnosis; D011693:Purpura / Q000209:etiology / Q000276:immunology*