1/4. Retinopathy in a patient with thrombotic thrombocytopenic purpura complicated by polymyositis.BACKGROUND: Cotton wool spots are known to be a complication in patients with thrombotic thrombocytopenic purpura or with polymyositis. CASE: A 53-year-old woman developed numerous cotton wool spots around the optic disc of both eyes. OBSERVATIONS: fluorescein angiography disclosed capillary obstruction and microaneurysms in the early phase, followed by dye leakage in the late phase. Systemically, she showed fever, hemolytic anemia, fragmented red blood cells, thrombocytopenia, proximal muscle weakness, and elevation of serum muscle enzymes. This led to a diagnosis of thrombotic thrombocytopenic purpura complicated by polymyositis. CONCLUSION: We believe that this is the first case of thrombotic thrombocytopenic purpura complicated by polymyositis to develop cotton wool spots.- - - - - - - - - - ranking = 1keywords = thrombocytopenic, purpura (Clic here for more details about this article) |
2/4. Primary cutaneous nocardiosis in 2 patients on immunosuppressants.Two female cases of primary cutaneous nocardiosis due to nocardia brasiliensis are described. The first was associated with polymyositis and the second with chronic immune thrombocytopenic purpura. Both patients had received corticosteroids. In both cases the responsible actinomycetes were sensitive to trimethoprim/sulfamethoxazole. This drug was administered to both patients with excellent results. Treatment was continued for 3 months to prevent recurrence, a common consequence of short-term therapy. N. brasiliensis should be included in the differential diagnosis of any case of nodular lymphangitis, especially in immunocompromized patients.- - - - - - - - - - ranking = 0.14285714285714keywords = thrombocytopenic, purpura (Clic here for more details about this article) |
3/4. Thrombotic thrombocytopenic purpura and myoglobinuric acute renal failure following radiation therapy in a patient with polymyositis and cervical cancer.A 73-year-old woman was admitted to receive radiation treatment for uterine cervical cancer, however a complex series of events ensued, leading to death. She developed an acute exacerbation of polymyositis complicated by thrombotic thrombocytopenic purpura, rhabdomyolysis and acute renal failure. radiation therapy may have produced an immune disturbance leading to the acute exacerbation of polymyositis. Auto-immune-mediated endothelial damage might have triggered a series of events leading to thrombotic thrombocytopenic purpura. rhabdomyolysis seemed to be the main cause of acute renal failure.- - - - - - - - - - ranking = 0.85714285714286keywords = thrombocytopenic, purpura (Clic here for more details about this article) |
4/4. hepatic veno-occlusive disease in a case of polymyositis associated with thrombotic thrombocytopenic purpura/hemolytic uremic syndrome.A 50-year-old woman was treated with prednisolone for polymyositis. During the therapy, thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS) occurred. Neither plasma infusion nor plasma exchange could relieve the clinical manifestations of TTP/HUS. Moreover, massive ascites appeared and worsened her condition. She died approximately one year after the diagnosis of polymyositis. The autopsy revealed centri-lobular hepatic necrosis and nonthrombotic obliteration of hepatic small veins. The diagnosis of hepatic veno-occlusive disease (VOD) was made. It was suspected that common factors other than cytoreductive therapy had damaged the endothelium and caused TTP/HUS and VOD in a case of polymyositis.- - - - - - - - - - ranking = 0.71428571428571keywords = thrombocytopenic, purpura (Clic here for more details about this article) |