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Are there specific haemostatic abnormalities in children surviving septic shock with purpura and having skin necrosis or limb ischaemia that need skin grafts or limb amputations?
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More than 10% of children surviving septic shock with purpura have skin necrosis or limb ischaemia (SNLI.). Among 44 children consecutively admitted to our pediatric intensive care unit, 35 (80%) survived, 6 of them (17%) developed SNLI (defined as the need of a surgical procedure). Two timed
Henoch-Schönlein Purpura With Testicular Necrosis: Sonographic Findings at the Onset, During Treatment, and at Follow-up.
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Henoch-Schönlein purpura (HSP) with involvement of the testes is extremely rare. Here, we present a pediatric case of HSP involving testicular ischemic necrosis in an 8-year-old child. Ultrasonography plays an important role not only in the differential diagnosis at onset, but also in the assessment
Massive myocardial necrosis in thrombotic thrombocytopenic purpura: a case report and review of the literature.
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Thrombotic thrombocytopenic purpura (TTP) is an uncommon syndrome resulting from diffuse occlusion of small arterioles and capillaries by hyaline microthrombi. It is characterized by fever, thrombocytopenic purpura, microangiopathic hemolytic anemia, and neurologic and renal dysfunction. While
Fatal Pancreatic Necrosis after Pregnancy-Associated Thrombotic Thrombocytopenic Purpura.
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Thrombotic thrombocytopenic purpura (TTP) is a systemic disease characterised by the presence of microvascular thrombi resulting from endothelial injury and platelet activation. Vascular occlusion leads to the clinical manifestations of ischaemicorgan damage, microangiopathic haemolytic anaemia and
[Acute necrosis of the thoracic esophagus and ileum complicating rheumatoid purpura].
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A child is described who developed acute ischaemic necrosis of the oesophagus complicating an otherwise typical case of anaphylactoid purpura. This episode was preceded by a necrotising ileitis requiring intestinal resection and ileostomy. The histological similarities of the lesions in the
Ischemic necrosis of bile ducts complicating Schönlein-Henoch purpura.
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Gastrointestinal complications of Schönlein-Henoch purpura are frequent and sometimes severe. However, there seem to be no reports of liver involvement. A child is described in whom Schönlein-Henoch purpura was complicated by bile duct lesions, resulting in biliary cirrhosis and requiring liver
[Necrosis of maxilla secondary to purpura fulminans. A case report].
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Purpura fulminans in infants is a rare, life-threatening condition mostly due to Neisseria meningitides. The condition is often fatal unless there is early recognition of the clinical symptoms, prompt diagnosis, and judicious replacement therapy. We observed a case of maxilla necrosis in a
Penile necrosis secondary to purpura fulminans: a case report and review of literature.
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We report the case of a 60-year-old Hispanic male with widespread necrotic purpuric lesions involving the penile, suprapubic, inguinal and hip dermis due to purpura fulminans. Purpura fulminans describes a rare syndrome involving intravascular thrombosis and hemorrhagic infarction of the skin; this
Thrombotic thrombocytopenic purpura first seen as massive vaginal necrosis.
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Thrombotic thrombocytopenic purpura is a hematologic disorder that affects the microcirculation. A 38-year-old woman was first seen with fever, thrombocytopenia, and vaginal bleeding. Pelvic examination revealed massive vaginal necrosis. Hematology consultation resulted in agreement with the
Penile Necrosis as a Presenting Sign of Purpura Fulminans Mimicking Fournier's Gangrene
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We report the case of a 63-year-old white man who, 3 days after stent removal of endoscopic drainage of pancreatic cysts, developed a penile necrosis due to purpura fulminans (PF) that has been misdiagnosed as Fournier's gangrene. Penile necrosis was rapidly followed by a lethal multiorgan failure
Acute Esophageal Necrosis Presenting With Henoch-Schönlein Purpura.
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A 63-year-old woman with abdominal pain and melena developed a palpable, purpuric rash and acute kidney injury. Skin and kidney biopsy confirmed Henoch-Schönlein purpura. Upper endoscopy revealed diffuse, circumferential, black-appearing mucosa of the esophagus consistent with acute esophageal
Palpable purpura complicated by streptococcal toxic shock syndrome resulting in limb necrosis and amputation: a case of levamisole and cocaine coingestion.
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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
Bone Marrow Necrosis in Sickle Cell-Beta Thalassemia Patient Mimicking Thrombotic Thrombocytopenic Purpura.
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We describe a case of bone marrow necrosis (BMN) with subsequent fat embolism precipitated by high altitudes in a young healthy man with previously undiagnosed sickle cell-beta thalassemia. This case report adds to the growing literature on the complexity of diagnosing bone marrow necrosis given
Coumarin necrosis, neonatal purpura fulminans, and protein C deficiency.
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Protein C (PC), a 62,000-molecular weight vitamin K-dependent serine protease zymogen, is a natural anticoagulant that occurs in plasma at 4 mg/L. Activated PC inactivates clotting factors V and VIII and is also profibrinolytic. Activated PC is enhanced in its anticoagulant activity by protein S
Kawasaki disease differs from anaphylactoid purpura and measles with regard to tumour necrosis factor-alpha and interleukin 6 in serum.
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It has been reported that tumour necrosis factor-alpha (TNF-alpha) is capable of inducing vascular injury, and interleukin 6 (IL-6) of inducing production of acute phase proteins and the maturation of megakaryocytes. Kawasaki disease (KD) is a systemic vasculitis with severe inflammation. We
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