title: [Grönblad-Strandberg syndrome from the angiological viewpoint].
abstract: METHODS
  A 42-year-old man was admitted for treatment of peripheral vascular disease in the left leg (stage III of Fontaine). A year before he had undergone a right aortofemoral bypass operation. On admission there was stenosis of the left pelvic axis and bilateral femoral artery occlusion. In addition there were changes in the skin with abnormal folds, loss of elasticity and yellowish spots over the sides of the neck and the flexor surfaces of all large joints. In addition vision in the left eye was impaired. These findings suggested connective tissue disease involving the skin, eye and arterial system.
  
  
  METHODS
  Routine haematological tests were normal as were clotting parameters. Serum concentration of GOT, GPT, gamma-GT were slightly increased. There was a dysproteinaemia with raised HDL and LDL levels. Resting electrocardiogram was normal, showing sinus rhythm and left axis deviation. The crurobrachial pressure index was clearly abnormal: 0.6 on the right and 0.5 on the left. Angiography of the pelvic and left arteries revealed long-segment femoral and partial lower-leg occlusions bilaterally. Abdominal sonography indicated diffuse parenchymal calcifications in both kidneys and angioid streaks on bilateral fundoscopy. Skin biopsy showed defects of elastic fibres and perivascular inflammatory infiltration, while capillary microscopy revealed twisting of the capillaries, most of them with normal lumen. These findings taken together indicated pseudoxanthoma elasticum (PXE) or Grönblad-Strandberg syndrome.
  
  
  METHODS
  A thrombendarterectomy was performed on the left superficial femoral artery, after which the left popliteal artery became palpable, the pressure indices for the left leg were slightly better, and the patient was discharged home without further complications and improved leg perfusion.
  
  
  CONCLUSIONS
  Possible cardiovascular involvement had to be taken into account in patients with PXE, and long-term angiological monitoring is indicated.
authors.affiliation: Medizinische Klinik und Poliklinik I, Universität Leipzig.
authors.forename: C
authors.initials: C
authors.lastname: Rühlmann
authors.forename: I
authors.initials: I
authors.lastname: Wittig
authors.forename: A
authors.initials: A
authors.lastname: Lochner
authors.forename: B
authors.initials: B
authors.lastname: Klötzer
authors.forename: B
authors.initials: B
authors.lastname: Wilke
authors.forename: M
authors.initials: M
authors.lastname: Mittag
authors.forename: D
authors.initials: D
authors.lastname: Pfeiffer
mesh_terms: D000328:Adult; D001157:Arterial Occlusive Diseases / Q000209:etiology / Q000601:surgery; D004691:Endarterectomy; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D008297:Male; D011561:Pseudoxanthoma Elasticum / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery
vernacular_title: Das Grönblad-Strandberg-Syndrom aus angiologischer Sicht.