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Autoerythrocyte Sensitization

(Gardner-Diamond Syndrome; Painful Bruising Syndrome)

By David J. Kuter, MD, DPhil, Professor of Medicine, Harvard Medical School; Chief of Hematology, Massachusetts General Hospital

Autoerythrocyte sensitization causes painful bruises, usually on the arms or legs.

Autoerythrocyte sensitization is rare. It typically occurs in white women who are experiencing emotional stress.

Doctors are not sure of the cause. One theory is that the body somehow becomes sensitive to its own red blood cells (erythrocytes). Thus, red blood cells that escape from the blood vessels may cause an allergic-type reaction that leads to the bruising. However, most affected people also have symptoms of mental disorders.

People develop episodes of painful bruising. Bruises may develop spontaneously or after injury or surgery. Bruising can occur on different sites of the body from where the injury occurs. Bruises then resolve after a few days. Some people also have nausea, vomiting, and headaches.

Doctors first do tests of the blood clotting system. If the results are normal (meaning that a blood clotting disorder that causes bruising is unlikely), doctors may then inject a small sample of the person's own red blood cells into the skin. They also inject a control site with a salt solution that will not cause a reaction. After 24 to 48 hours, doctors examine both injection sites to determine whether there has been a reaction to the red blood cells.

Bruises resolve on their own. Some people benefit from treatment that helps them deal with emotional stress.