title: Unilateral emboli in a patient with thrombotic thrombocytopenic purpura.
abstract: Thrombotic thrombocytopenic purpura is a rare disease most commonly associated with microangiopathic hemolytic anemia, thrombocytopenia, fever, neurologic disorders, and renal dysfunction. We describe a patient with a history of thrombotic thrombocytopenic purpura that had been quiescent for 4 months; he had a 3-week history of painful purpuric lesions on the left hand only. He also had mottling and a livedoid purpura of the distal fingertips, splinter hemorrhages of the left fingernails, and a decreased radial pulse. Findings of a biopsy specimen revealed multiple capillary and small vessel thromboses. Contrast aortography demonstrated a pseudoaneurysm of the proximal descending thoracic aorta with stenosis of the left subclavian artery at its origin and an associated thrombus.
authors.affiliation: Department of Medicine, University of Louisville School of Medicine, KY.
authors.forename: J B
authors.initials: JB
authors.lastname: Burruss
authors.forename: L M
authors.initials: LM
authors.lastname: Cohen
authors.forename: H A
authors.initials: HA
authors.lastname: Thomas
authors.forename: J P
authors.initials: JP
authors.lastname: Callen
mesh_terms: D000328:Adult; D017545:Aortic Aneurysm, Thoracic / Q000150:complications* / Q000000981:diagnostic imaging; D001027:Aortography; D001706:Biopsy; D004617:Embolism / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D011697:Purpura, Thrombotic Thrombocytopenic / Q000150:complications*