Sneddon's syndrome (livedo racemosa and cerebral infarction) presenting psychiatric disturbance and shortening of fingers and toes.
A 24-year-old man with livedo racemosa and psychiatric disturbances, manifesting as low intelligence (IQ 80) and delusions, had anti-cardiolipin antibody and showed shortening of the fingers and toes. A skin biopsy of the livedo lesion revealed endoarteritis obliterans, being compatible with Sneddon's syndrome. MRI of the brain demonstrated multiple infarction and moderate cortical atrophy. A single photon emission tomography of the brain showed a marked reduction of the blood flow in the front-temporal lobe. These findings might relate to the psychiatric disturbance. After intravenous administration of cyclophosphamide and the start of oral prednisolone, the anti-cardiolipin antibody level decreased and his physical condition improved. However, a low dose of haloperidol is still necessary to maintain his mental condition.
Third Department of Internal Medicine, Akita University School of Medicine.
M
M
Kume
H
H
Imai
M
M
Motegi
A B
AB
Miura
I
I
Namura
D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000097:blood; D001921:Brain / Q000473:pathology; D003702:Delusions; D005385:Fingers / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012867:Skin / Q000473:pathology; D018860:Sneddon Syndrome / Q000175:diagnosis* / Q000473:pathology / Q000523:psychology; D014034:Toes / Q000473:pathology
D017153:Antibodies, Anticardiolipin