Gardner-Diamond syndrome

What causes Gardner-Diamond syndrome?

The underlying cause of Gardner-Diamond syndrome (GDS) is poorly understood and has not been identified. Experts have proposed several possible explanations including:

  • response to stress - stress, or distress, is associated with increased levels of glucocorticoids and catecholamines in the body, which may alter processes such as fibrinolysis (the breakdown of blood clots)
  • increased fibrinolysis - an increase in the activity of tissue plasminogen activator (tPA), which can cause a cascade of events that may lead to bleeding
  • autoerythrocyte sensitization - an autoimmune reaction to the affected person's own red blood cells (erythrocytes)

Last updated on 05-01-20

How is Gardner-Diamond syndrome diagnosed?

There are no specific laboratory tests that can confirm the diagnosis of Gardner-Diamond syndrome (GDS), but various tests may be used to rule out other conditions. The diagnosis may be considered based on the presence of symptoms, when all other causes of bleeding have been ruled out (including the use or misuse of various medications that may be associated with bleeding). A detailed psychiatric evaluation is of huge importance if GDS is suspected, with information concerning how the person has responded to major stressful events in his or her life (such as fetal losses, death in the family, divorce, loss of income). While the underlying cause of GDS is unknown, an abnormal psychiatric history is virtually always present.

Last updated on 05-01-20

Are psychiatric symptoms or stressful events always associated with the diagnosis of Gardner-Diamond syndrome?

It is common for people with Gardner-Diamond syndrome to have a history of psychiatric symptoms or stressful events in their lives. It is important to remember that having a history or emotional distress or mental illness does not mean that the symptoms related to Gardner-Diamond syndrome are any less real. It is important to seek comprehensive medical treatment for these symptoms, even if they were partly caused by emotional distress.

In some cases, Gardner-Diamond syndrome may occur in a person who does not have this history of emotional distress or trauma. In these cases, it is not clear exactly what causes the symptoms associated with the syndrome. Some researchers believe that Gardner-Diamond syndrome is a type of autoimmune disease. In general, autoimmune diseases are thought to be caused by a combination of genetic and environmental factors. This would mean that emotional stress is not necessary for a person to have Gardner-Diamond syndrome.

Last updated on 05-01-20

What is Gardner-Diamond syndrome?

Gardner-Diamond syndrome (GDS) is a rare condition characterized by episodes of unexplained, painful bruising that mostly occurs on the arms, legs, and/or face. It 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 burning, redness and swelling. Most affected people report that the bruising occurs either spontaneously, or some time after trauma or surgery at other sites of the body. The cause of GDS is poorly understood. Management typically involves psychiatric treatment.

Last updated on 05-01-20

What is the long-term outlook for people with Gardner-Diamond syndrome?

The overall outlook (prognosis) for people with Gardner-Diamond syndrome (GDS) is good. However, relapses and remissions are common and may last for several years. Remissions may be long-lasting. Relief of acute stress and psychological factors is crucial in longer remissions. Chronological recurrence around the anniversary mark of major life events is common.

In some cases, symptoms of GDS may persist and even worsen.The onset of new lesions is most probable after physical trauma or stress.

Last updated on 05-01-20

How many people have Gardner-Diamond syndrome?

Gardner-Diamond syndrome (GDS) is an extremely rare disorder. An article published in 2015 noted that about 200 cases worldwide have been reported in the literature since GDS was first described in the 1950s. Most cases reported have occurred in women ages 19-72, and mainly in women younger than age 30. Cases in men and in children have also been reported.

Last updated on 05-01-20

How might Gardner-Diamond syndrome be treated?

There is no specific treatment for Gardner-Diamond syndrome (GDS). It has been suggested that psychiatric treatment (including psychotherapy) is the only reasonable therapeutic option. In some people, psychiatric medications for mental illness have helped to improve the symptoms. For example, in a person with GDS and an underlying personality disorder, medications used to treat the personality disorder may help with the symptoms of GDS. Due to the presumed psychological nature of the disease, placebo effect has been used successfully to ease the severity of symptoms.

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 useful for some people.

Symptomatic therapy may be helpful for severe, general symptoms. Several approaches including antihistamines, corticosteroids, antidepressants, hormones, and vitamins have had variable success.

Last updated on 05-01-20

Selected Full-Text Journal Articles

Journal articles - Gardner-Diamond syndrome

Last updated on 04-27-20

Psychogenic Purpura (Gardner-Diamond Syndrome) Full-Text

Jafferany M, Bhattacharya G. Psychogenic Purpura (Gardner-Diamond Syndrome). Prim Care Companion CNS Disord. 2015 Jan 22;17(1).

Last updated on 04-27-20

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