Recurrent Ecchymoses and Cutaneous Hyperreactivity to Hemoglobin: A Form of Autoerythrocyte Sensitization

Author:

KREMER WILLIAM B.12,MENGEL CHARLES E.13,NOWLIN JOHN B.14,NAGAYA HIROSHI15

Affiliation:

1. Department of Medicine and the Lane Research Laboratory, Duke University Medical Center, Durham, North Carolina.

2. Division of Hematology, Department of Medicine, Duke University Medical Center, Durham, N. C.; formerly U.S. Public Health Service Trainee in Hematology and Cancer Research (T4 CA 5042).

3. John and Mary Markle Scholar in Academic Medicine, and Director, Division of Hematology and Oncology, Ohio State University College of Medicine, Columbus, Ohio.

4. Division of Behavioral Medicine, Department of Medicine, Duke University Medical Center, Durham, N. C.

5. Division of Allergy, Department of Medicine, Duke University Medical Center, Durham, N. C.

Abstract

Abstract A patient with recurrent painful ecchymoses was presented with features similar to those described for patients with autoerythrocyte sensitization. This patient differed in that she was reactive to the red cell hemolysate and purified hemoglobin and not to red cell lipid, red cell stroma, or leukocyte DNA. No evidence was found to support the hypothesis that the abnormal vascular reaction involved an immunologic mechanism. The patient was observed forcibly inducing bruises but not manipulating the skin tests. It was concluded that a cutaneous hyperreactivity to hemoglobin in association with psychological disturbances was responsible for the painful ecchymoses in this patient.

Publisher

American Society of Hematology

Subject

Cell Biology,Hematology,Immunology,Biochemistry

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