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Genetic and Rare Diseases Information Center (GARD)

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Gardner-Diamond syndrome


Other Names for this Disease

  • Autoerythrocyte sensitization
  • Autoerythrocyte sensitization purpura
  • Painful bruising syndrome
  • Psychogenic purpura
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.

Overview

What is Gardner-Diamond syndrome?

What are the signs and symptoms of Gardner-Diamond syndrome?

What causes Gardner-Diamond syndrome?

How is Gardner-Diamond syndrome diagnosed?

How might Gardner-Diamond syndrome be treated?

What is Gardner-Diamond syndrome?

Gardner-Diamond syndrome is a condition characterized by episodes of unexplained, painful bruising, mostly occurring on the arms, legs, trunk and/or face.[1][2] The disorder is most common in Caucasian women who have mental illness or emotional stress. Symptoms typically include the formation of multiple, small, purple bruises that may be associated with redness and swelling. Most affected individuals report that the bruising occurs either spontaneously or some time after trauma or surgery. The cause of the condition is poorly understood. Management typically involves psychiatric treatment.[1]
Last updated: 9/12/2011

What are the signs and symptoms of Gardner-Diamond syndrome?

Individuals affected with Gardner-Diamond syndrome have reported that bruises occur either spontaneously or after trauma or surgery at other sites of the body. Some individuals are able to pinpoint exactly when the bruising occurred, while others are not.[1] Episodes may begin with sensations that include burning, stinging, or pain which may be accompanied by a general feeling of malaise or fatigue.[1][2] This may be followed by warmth, puffiness, redness and/or itching in the affected area(s) of the body. In some cases, the development of the bruises may also be accompanied by various things including fever, headache, or gastrointestinal symptoms. Individuals have reported that the pain generally subsides when bruises appear. Sometimes, the pain and swelling may be very severe, causing the affected body part to become immobilized.[1] Bruises typically disappear in approximately 7-10 days.[2] In the majority of affected individuals, relapses and remissions of bruising episodes can last for many years. In some cases, symptoms of the condition persist and may worsen. Subsequent episodes are most likely to occur after some sort of physical trauma or stress.[2]
Last updated: 9/14/2011

What causes Gardner-Diamond syndrome?

The cause of Gardner-Diamond syndrome is not understood. It is generally accepted that episodes associated with the syndrome are provoked by stress (hence why it is also called psychogenic purpura). However, it is unclear exactly how stress causes the symptoms of the condition.[2] Other mechanisms that have been proposed to play a role in causing the condition include:[1]
  • an increase in the local activity of a specific protein involved in the breakdown of blood clots (tissue plasminogen activator), which can cause a cascade of events that may lead to bleeding
  • an autoimmune reaction to the affected individual's own red blood cells (erythrocytes)
Last updated: 9/12/2011

How is Gardner-Diamond syndrome diagnosed?

There are no specific tests that can confirm the diagnosis of Gardner-Diamond syndrome. The diagnosis may be considered when an individual has the signs and symptoms of the condition but all other causes of bleeding have been ruled out. A positive intracutaneous test with autoerythrocytes may also be helpful in making a diagnosis.[2] This is essentially an injection of autoerythrocytes into the skin to determine if an allergic reaction is present. Additionally, a detailed psychiatric evaluation is extremely important when a diagnosis of this syndrome is suspected because an abnormal psychiatric history is typically present in affected individuals.[1]
Last updated: 9/14/2011

How might Gardner-Diamond syndrome be treated?

Unfortunately, there is currently no known effective treatment for Gardner-Diamond syndrome. In some affected individuals, psychiatric medications for mental illness have helped to improve the symptoms. For example, in an affected individual with an underlying personality disorder, medications typically used to treat the personality disorder may help with the symptoms of Gardner-Diamond syndrome. Psychotherapy, hypnotherapy and suggestive therapy have also been shown to improve skin condition and psychological disorders in younger individuals. It has been proposed that certain medications used to alter the tonus of the capillaries (how they contract), the permeability of the vessels and/or the flowing properties of the blood may be advised for some individuals.[2]
Last updated: 9/14/2011

References
  1. Benjamin P Geisler, Bruce J Dezube. Psychogenic purpura (Gardner-Diamond syndrome). UpToDate. January 19, 2011; http://www.uptodate.com/contents/psychogenic-purpura-gardner-diamond-syndrome. Accessed 9/12/2011.
  2. OL Ivanov, AN Lvov, AV Michenko, J Künzel, P Mayser, U Gieler. Autoerythrocyte sensitization syndrome (Gardner–Diamond syndrome): review of the literature. Journal of the European Academy of Dermatology and Venereology. 2009; 23(5):499-504.


Other Names for this Disease
  • Autoerythrocyte sensitization
  • Autoerythrocyte sensitization purpura
  • Painful bruising syndrome
  • Psychogenic purpura
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.