Autoerythrocyte sensitization syndrome (Gardner-Diamond syndrome): review of the literature**

Abstract

A review of the literature concerning psychogenic purpura is presented. The diagnosis is usually based on typical anamnestic data, clinical presentation (painful inflammatory skin lesions, which progressed to ecchymoses during the next 24 h) and positive diagnostic tests with intracutaneous injections of 80% solution of washed autologous erythrocytes. No pathological findings of blood coagulation parameters are usually detected. Histopathological evaluations of lesional biopsies revealed non-specific changes. Taking into account the high frequency of psychic disorders and stress dependence of skin symptoms, therapy with psychotropic drugs (according to indications) and psychotherapy are pathogenetically grounded methods of treatment in psychogenic purpura, and should be provided together with symptomatic therapy.

Perplexing purpura in two females: Rare case of autoerythrocyte sensitization syndrome

“…[2] Auto-sensitization of patients to their own blood, mainly to phosphatidylserine (phosphoglyceride of red blood cell (RBC) membrane) plays an important role in the pathogenesis. [1] Struneckα et al ., showed that more than 50% of the erythrocyte phosphatidylserine of patients with GDS was redistributed on the outer leaflet of the cell membrane. They also found disorder in cytoskeleton organization of RBCs in such patients.…”

“…Some authors have revealed auto-sensitization to hemoglobin and deoxyribonucleic acid. [13] Merlen suggested that fluctuations in the kallikerin-kinin system lead to disturbance in the tonus regulation of the venous capillaries. [4] Also there is disturbance in the fibrin synthesis in the endothelium, formation of defective structures of capillary walls and extravasation of erythrocytes carrying sensitizing antibodies.…”

Recurrent self-healing painful ecchymoses and fever: a case of Gardner-diamond syndrome

“…A positive erythrocyte autosensitization test is a distinctive, though not characteristic finding of patients with GDS. 3,4 The pathophysiological mechanism underlying the erythrocyte autosensitization in GDS is not known. Phosphatidylserine a phosphoglyceride of red blood cell membrane is considered to play an important role in the pathogenesis of this condition.…”

Self-Inflicted Lesions in Dermatology: Terminology and Classification – A Position Paper from the European Society for Dermatology and Psychiatry (ESDaP)

“…Gardner-Diamond-syndrome ("painful ecchymosis syndrome", "psychogenic purpura" or "painful bruising syndrome") was originally attributed to an autoimmune mechanism ("auto-erythrocyte sensitization syndrome"), but has now been classified as a factitious disorder (32,33).…”