Unilateral emboli in a patient with thrombotic thrombocytopenic purpura

• Published in: Journal of the American Academy of Dermatology Vol. 29; no. 5; pp. 838 - 840
• Main Authors: Burruss, Jyoti B., Cohen, Lisa M., Thomas, Hollis A., Callen, Jeffrey P.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.11.1993; Elsevier
• Subjects: Adult; Aortic Aneurysm, Thoracic - complications; Aortic Aneurysm, Thoracic - diagnostic imaging; Aortography; Biological and medical sciences; Biopsy; Embolism - etiology; Embolism - pathology; Hematologic and hematopoietic diseases; Humans; Male; Medical sciences; Platelet diseases and coagulopathies; Purpura, Thrombotic Thrombocytopenic - complications; Human; Skin disease; Nervous system diseases; Urinary system disease; False aneurysm; Vascular disorders of the skin; Hemopathy; Thrombosis; Thoracic aorta; Case study; Thrombotic thrombocytopenic purpura; Platelet; Hemolytic anemia; Left subclavian artery; Capillary vessel disease; Complication
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/0190-9622(93)70250-W

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.