Unilateral emboli in a patient with thrombotic thrombocytopenic purpura.
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.
Burruss
J B
JB
Department of Medicine, University of Louisville School of Medicine, KY.
Cohen
L M
LM
Thomas
H A
HA
Callen
J P
JP
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*