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thrombocytopenia purpura of legs

Donavan de Souza Lúcio, Jacqueline Foelkel Pignatari, Marcelo Gil Cliquet, Henri Augusto Korkes
CONTEXT: Thrombotic microangiopathy syndrome or thrombotic thrombocytopenic purpura-hemolytic uremic syndrome (TTP-HUS) describes distinct diseases sharing common pathological features: microangiopathic hemolytic anemia and thrombocytopenia, without any other apparent cause. CASE REPORT: An 18-year-old second-trimester primigravida presented with a history of fifteen days of intense weakness, followed by diarrhea over the past six days. She reported having had low platelets since childhood, but said that she had never had bleeding or menstrual abnormalities...
September 2017: São Paulo Medical Journal, Revista Paulista de Medicina
Christian P Nixon, Tracey A Cheves, Joseph D Sweeney
BACKGROUND: Drug-induced immune thrombocytopenia (DITP) is a rare clinical disorder characterized by accelerated platelet (PLT) clearance in the presence of drug-dependent antibodies. Distinguishing DITP from other immune-mediated disorders such as posttransfusion purpura (PTP) and autoimmune thrombocytopenia can represent a clinical challenge. CASE REPORT: A 68-year-old male with no prior transfusion history presented to the emergency department (ED) with dyspnea, epistaxis, and severe thrombocytopenia (<10 × 10(9)/L) 12 days after discharge from a hospital admission for a coronary artery bypass graft...
November 2015: Transfusion
Monika Houstoun, Marsha E Reichman, David J Graham, Sumathi Nambiar, Hala Shamsuddin, S Christopher Jones, Kelly Cao, Michael Wernecke, Chelsea Lam, Chris M Worrall, Thomas E MaCurdy, Jeffrey A Kelman
PURPOSE: In 2005, the Food and Drug Administration approved Qualaquin (quinine) for treatment of malaria and later ordered unapproved quinine formulations off the market. In 2009, labeling for Qualaquin added a warning for use for leg cramps, as serious hematologic reactions could occur. We examined quinine use trends among Medicare beneficiaries focusing on indications for use and associations with adverse hematologic outcomes. METHODS: Medicare beneficiaries, aged 65 years and older, in 2006-2012, were included in incident quinine or comparator, diltiazem, cohorts if 183 days prior to dispensing, they were enrolled in Medicare, had no dispensing of quinine, diltiazem, ticlodipine, clopidogrel, and sulfonamide drugs, and had no diagnoses of thrombocytopenia, immune thrombocytopenic purpura (ITP), thrombotic microangiopathy (TMA), or hemolytic-uremic syndrome (HUS)...
September 2014: Pharmacoepidemiology and Drug Safety
Rekha Bansal, Parveen K Sharma, Aradhna Sharma
A 32-year-old male patient was diagnosed as having pulmonary tuberculosis and put on category II antitubercular regime since he had a history of antituberculosis treatment 10 years ago. Within 3 weeks, patient presented with ulcers in mouth, and blood picture confirmed thrombocytopenia. Rifampicin-induced thrombocytopenia was suspected and antitubercular treatment stopped. Patient improved and was re-exposed to the drugs one by one. After re-exposure with pyrazinamide, the platelet count decreased drastically and oral mucosal ecchymoses reappeared, while with rifampicin, thrombocytopenia was accompanied with petechiae on legs and forearms...
July 2013: Indian Journal of Pharmacology
Mehmet Sinan Dal, Tuba Dal, Recep Tekin, Erdal Bodakçi, Yakup Düzköprü, Mehmet Orhan Ayyildiz
Tuberculosis is still one of the most prevalent and fatal infectious diseases in spite of considerable improvements in medical science. Splenic tuberculosis is a rare form of extrapulmonary tuberculosis. There are limited numbers of cases in which immune thrombocytopenia is associated with splenic tuberculosis. We report a case of immune thrombocytopenic purpura due to splenic tuberculosis. Our case was a 58-year-old female with headache, gum bleeding, redness in legs, and ecchymoses on the arms for 10 days...
March 2013: Le Infezioni in Medicina
Tatsunori Ishikawa, Masanori Makita, Kyosuke Saeki, Yoshitaka Hara, Kazuhiko Yamamoto, Kenji Imajo
Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disease that is a rare complication of thienopyridine treatment, especially clopidogrel. Here we report a case of clopidogrel-associated TTP. A 77-year-old male initially complained of petechiae on his legs 6 weeks after clopidogrel treatment following coronary artery stenting. He was admitted 4 weeks later with slurred speech and low-grade fever. Laboratory findings showed severe thrombocytopenia, hemolytic anemia with fragmented red cells, renal dysfunction and severe deficiency of ADAMTS13 activity with the presence of the inhibitor...
June 2012: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Craig W Freyer, Michael Peters
Palpable purpura resulting from cocaine and levamisole coingestion has been reported with increasing frequency over the last several years as distribution of this drug combination becomes more universal. Toxicity from ingestion of this dangerous combination is difficult to diagnose due to the multitude of possible clinical presentations, variety of possible adulterants, and elusive nature of levamisole given its short half-life and limited availability of detection methods. Levamisole is a chemotherapeutic and immunomodulatory agent currently marketed as a veterinary anthelmintic...
February 2012: Pharmacotherapy
Yuko Kurihara, Takashi Shishido, Kayo Oku, Masashi Takamatsu, Hiroshi Ishiguro, Atsushi Suzuki, Tsunejirou Sekita, Toshihito Shinagawa, Tadayuki Ishihara, Ran Nakashima, Takao Fujii, Yutaka Okano
We describe a 40-year-old woman with polymyositis (PM) who developed autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), and autoimmune thrombocytopenic purpura (AITP) concurrently. About 4 years earlier, she suffered from muscle weakness probably due to PM. When she visited our hospital, she had polyarthritis, myalgia, symmetrical proximal limb-muscle weakness, elevated muscle enzymes, and myogenic abnormalities on electromyogram. Pathological findings obtained by muscle biopsy showed histological findings consistent with PM...
June 2011: Modern Rheumatology
Ralph Salloum, Chin Y Liu, Amy M Weise
PURPOSE: A possible case of levofloxacin-induced thrombocytopenia is reported. SUMMARY: A 73-year-old Caucasian woman with stage IV squamous cell cancer of the oral cavity arrived at the hospital with a 6-day history of epistaxis; petechiae over her arms, legs, and abdomen; and bruises over her forearms. Her comorbidities included hypertension, type 2 diabetes mellitus, and coronary artery disease. Two weeks before arrival at the hospital, the patient had been admitted to the hospital with community-acquired pneumonia (CAP) and given a 10-day course of levofloxacin 500 mg daily, which she completed 4 days before this admission...
January 1, 2011: American Journal of Health-system Pharmacy: AJHP
Tomoki Miyazawa, Keisuke Sugimoto, Shinsuke Fujita, Kohei Miyazaki, Yutaka Takemura, Hidehiko Yanagida, Naoki Sakata, Norihisa Wada, Mitsuru Okada, Tsukasa Takemura
We evaluated and treated a girl with Henoch-Schönlein purpura (HSP), who initially developed redness, swelling, and pain in all 4 limbs accompanied by Raynaud syndrome and then had convulsions and disturbance of consciousness. HSP was diagnosed based on later findings of purpura in both legs and a decrease in factor XIII activity not accompanied by thrombocytopenia. She was normotensive. A skin biopsy specimen showed small-vessel vasculitis accompanied by immunoglobulin A deposition. The cause of erythema and limb pain, convulsions, and disturbed consciousness presumably was vasculitis...
October 2010: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Sinan Akbayram, Murat Dogan, Erdal Peker, Cihangir Akgun, Ahmet Faik Oner, Hüseyin Caksen
Thrombotic thrombocytopenic purpura (TTP) is characterized by disseminated thrombotic occlusions located in the microcirculation and a syndrome of microangiopathic hemolytic anemia, thrombocytopenia, fever, and renal and neurologic abnormalities. Thrombotic thrombocytopenic purpura is encountered in a variety of clinical situations such as viral, bacterial, and mycobacterial infections, autoimmune disorders, drug reactions, connective tissue disease, and solid tumors. In this report, we present TTP in a case of brucellosis because of rare presentation...
June 2011: Clinical and Applied Thrombosis/hemostasis
Yara A Park, Shauna N Hay, Karen E King, Karen Matevosyan, Jessica Poisson, Amy Powers, Ravindra Sarode, Beth Shaz, Mark E Brecher
Thrombocytopenia with or without microangiopathy following quinine is often referred to as quinine "hypersensitivity." When schistocytes are present it is frequently termed "quinine-associated TTP/HUS." A severe deficiency of the vWF-cleaving protease, ADAMTS13, is associated with idiopathic TTP. A previous study of patients with "quinine-associated TTP/HUS" found that ADAMTS13 activities were not abnormal in 12/12 patients. A retrospective review of TTP patients with quinine-associated thrombotic microangiopathy (TMA) for whom ADAMTS13 was measured before plasma exchange was performed...
2009: Journal of Clinical Apheresis
M A Zuber
A 61-year-old male patient presented with petechiae on the arms and legs due to a thrombocytopenia of 3 Gpt/l (3000/microl). A butterfly rash on the patient's face suggested a diagnosis of systemic lupus erythematosus (SLE). The thrombocytopenia was due to autoimmune thrombocytopenia. The diagnosis of SLE could be excluded and the butterfly rash attributed to a laminar hemorrhage, an ecchymosis due to the autoimmune thrombocytopenia.
July 2009: Zeitschrift Für Rheumatologie
D Santoro, M Stella, S Castellino
We report a case of a relapse of Henoch-Schönlein Purpura (HSP) associated with intake of paracetamol (also known as acetaminophene) and codeine. A 69-year-old man presented with fever, gross hematuria, acute renal failure, palpable purpuric skin rash over the legs, feet and arms, arthralgias and abdominal discomfort. 1 week before he had started therapy with co-efferalgan (association of paracetamol and codeine) for cervical arthrosis. Blood test revealed increase in serum creatinine levels (2.6 mg/dl), CRP (375 mg/dl), with no thrombocytopenia or hypocomplementemia...
August 2006: Clinical Nephrology
Alessandra Semino, Marco Danova, Stefano Perlini, Giovanni Palladini, Alberto Riccardi, Vittorio Perfetti
Although it is recognized that aggressive soft tissue sarcomas may give rise to cardiac metastases, these manifestations are usually late and clinically silent, being the prevailing finding in exceptional cases. This report describes the occurrence of a massive cardiac metastasis at diagnosis of leg rhabdomyosarcoma in a middle-age adult. This manifestation was the cause of rapidly progressive congestive heart failure and, together with the unusual occurrence of autoimmune thrombocytopenia, led to difficult patient care with a significantly negative influence on the outcome...
February 2006: American Journal of Clinical Oncology
M A Osmanağaoğlu, S Osmanağaoğlu, H Bozkaya
We describe a pregnant woman with systemic lupus erythematosus, complicated by severe pre-eclampsia (the HELLP syndrome) and adult respiratory distress syndrome, who died in the intensive care unit. A 33-year-old multigravid woman was referred to our university hospital at 17 weeks' gestation because of an exacerbation of systemic lupus erythematosus with elevated liver enzymes and thrombocytopenia. At the time of admission, on physical examination she had revealed a butterfly rash over the cheeks, purpura, acute synovitis and oedema of the legs...
August 2004: Anaesthesia and Intensive Care
V Bladt, K Steengaard-Pedersen, L H Poulsen, O B Petersen, B Laursen, F d'Amore
In this study, we present a case of late-puerperal onset of thrombohemorrhagic complications in a 33-yr-old woman with known antiphospholipid syndrome (APS) and heterozygosity for factor V Leiden gene mutation. Antithrombotic prophylaxis with low-molecular-weight (LMW) heparin was given since the 12th gestational week. Pregnancy and cesarean delivery were uncomplicated. Five weeks postpartum, the patient developed a severe hemorrhagic diathesis with marked thrombocytopenia accompanied by vaginal, nasal and cutaneous bleeding...
December 2004: European Journal of Haematology
Rajendra S Baliga, C S Wingo
A 67-year-old white woman developed severe nausea, vomiting, diffuse abdominal cramping pain, and blurred vision followed by a syncopal episode after taking 1 tablet of quinine for leg cramps. Examination was significant for fever, elevated blood pressure, and confusion without any focal neurological deficits. Laboratory studies showed markedly elevated liver enzymes, elevated lactate dehydrogenase, anemia, thrombocytopenia, and acute renal failure. Peripheral smear showed many schistocytes and burr cells. She later recalled taking quinine more than 40 years before while on a trip to the Philippines...
December 2003: American Journal of the Medical Sciences
Stephen F D'Addario, Matthew E Bryan, Warren A Stringer, Sandra Marchese Johnson
Minocycline hydrochloride, a synthetic tetracycline, is a systemic antibiotic that has received much attention over the past several years. Currently, minocycline is considered the most widely prescribed oral antibiotic in the management of acne. Minocycline has been associated with autoimmune events, hepatitis, lupus-like syndromes, serum sickness, vasculitis, Sweet's syndrome, and hyperpigmentation. We report a case of a patient who developed drug-induced immune thrombocytopenic purpura (DITP) after taking minocycline...
June 2003: Journal of Drugs in Dermatology: JDD
Gitte Bjørn Hvilsom, Bodil Himmelstrup
The case presents a healthy woman in her fifties, who was admitted to hospital with clinical signs of diffuse or disseminated intravascular coagulation and thrombotic thrombocytopenic purpura even though she was respiratorily and circulatorily stable. She developed gastroenteritis four days after a dog bite. After a while she got painful and ischemic legs, and this was the cause of admission. The laboratory manifestations included severe thrombocytopenia, fibrin degradation products but no presence of schistocytes or fragmented red blood cells...
March 31, 2003: Ugeskrift for Laeger
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