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July 1974

About a Peculiar Form of Purpura

Am J Dis Child. 1974;128(1):78-79. doi:10.1001/archpedi.1974.02110260080014

Gentlemen! Six years ago I took the liberty to describe a patient with a peculiar symptom complex. This case was published in the transactions of our society on Oct 14, 1868. Since it is unlikely that all of you have read that report, I am moved to ask your permission to let me repeat the salient points. The patient was a 15-year-old boy who has gastroduodenitis in association with mild icterus. A few days later he developed pain in the phalangeal joints of both hands, but without swelling. A few days later still, extensive purpura of the skin of the abdomen and thighs appeared. Very soon thereafter, he developed severe intestinal symptoms consisting of intense colic, vomiting, and black stools. The abdominal pain was severe enough to prevent him from sleeping. There was severe abdominal tenderness in the region of the transverse colon, which was greatly distended and tympanitic. He

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