Blue digit syndrome: urgent indication for digital salvage

Lee, Bok Y.; Brancato, R; Thoden, William R.; Madden, John L.

doi:10.1016/0002-9610(84)90181-8

Cited by 16 publications

(4 citation statements)

References 3 publications

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“…Several different causes of PDIS have been recognized. Decreased tissue perfusion of the blood due to altered blood circulation (1,2), vasculitis (3–5), peripheral vascular spasm (6,7), peripheral vascular thrombotic diseases (8–10), and systemic thromboembolic diseases (11–13) are the known causes of PDIS.…”

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confidence: 99%

Peripheral Digit Ischemic Syndrome Can Be a Manifestation of Postoperative Thrombotic Thrombocytopenic Purpura

Chang

Ikhlaque

2004

Ther Apher Dial

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: In addition to common dysfunction of the brain and kidney, thrombotic thrombocytopenic purpura (TTP) may present with atypical clinical features due to the involvement of other organs such as the lung, pancreas, heart, eye, and skin. We have also observed the unusual presentation of peripheral digit ischemic syndrome (PDIS) in some patients with postoperative TTP. To clarify this relationship between TTP and PDIS, the hematologic data from the medical records of patients with known diagnoses of thrombotic microangiopathy (TM) were examined in a single institution. A total of 94 patients were diagnosed with TM. Among these patients, PDIS developed in six patients and in all these patients PDIS occurred with postoperative TTP. Four patients also had acute respiratory distress syndrome (ARDS). Because of delayed diagnosis of TTP, only two patients survived and four died. One patient responded to plasma exchange and survived, and another patient recovered from postoperative TTP without plasma exchange. However, both patients required the amputation of multiple digits. In conclusion, PDIS is another atypical manifestation of TTP and has occurred exclusively in patients with postoperative TTP in this series. Once PDIS developed, the prognosis was poor and amputation of digits was needed in surviving patients. Early recognition of this atypical manifestation of TTP is essential for a favorable outcome.

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confidence: 99%

Peripheral Digit Ischemic Syndrome Can Be a Manifestation of Postoperative Thrombotic Thrombocytopenic Purpura

Chang

Ikhlaque

2004

Ther Apher Dial

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“…This also explains the predominantly left-sided acute blue discoloration of fingers through microemboli caused by the stenosis. Endovascular procedures such as angioplasty with or without placing of a stent in combination with thrombocyte aggregation inhibitors have had very good successes in the treatment of microemboli in stenoses of the subclavian artery [6,8,9]. When symptoms of poststenotic malperfusion are lacking -as was the case here -anti-platelet therapy as monotherapy may be sufficient to prevent further embolic events [10].…”

Section: Discussionmentioning

confidence: 92%

Painful cyanotic discoloration of the distal phalanges IV and V of the left hand in a 53‐year‐old female smoker

Poppe

Bühler

et al. 2013

J Deutsche Derma Gesell

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“…202 They later showed that the addition of lumbar sympathectomy with surgical revascularization procedures for blue toe syndrome enhanced healing of pre-gangrenous lesions with a 100% digital salvage rate. 203 Lumbar sympathectomy appears to work by sympathetic blockade, improving collateral blood supply to the ischemic tissue and relieving cutaneous ischemia.…”

Section: Ldl Apheresismentioning

confidence: 99%

Atheromatous embolization

Liew

Bartholomew

2005

Vasc Med

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Atheromatous embolization is a multisystem disease complicating advanced atherosclerosis. It occurs most often as a complication of angiography, an endovascular procedure or cardiovascular surgery. Atheromatous embolization can present in a subtle manner where it is often under-recognized, or with catastrophic results including myocardial infarction, strake or acute renal failure. It may mimic other disease processes and often goes underdiagnosed and undertreated. A high clinical suspicion is the key to diagnosis. Atheromatous embolization results in significant morbidity and mortality; therefore, early recognition followed by aggressive management may help to prevent end-organ damage and improve overall clinical outcomes. Management strategies should include risk factor modification, prevention of further insults by discontinuing or avoiding predisposing factors, supportive treatment and interventional or surgical approaches to remove the atheroembolic source. Atheromatous embolization is expected to increase as our population ages and the epidemics of diabetes mellitus and obesity increase.

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Blue digit syndrome: urgent indication for digital salvage

Cited by 16 publications

References 3 publications

Peripheral Digit Ischemic Syndrome Can Be a Manifestation of Postoperative Thrombotic Thrombocytopenic Purpura

Peripheral Digit Ischemic Syndrome Can Be a Manifestation of Postoperative Thrombotic Thrombocytopenic Purpura

Painful cyanotic discoloration of the distal phalanges IV and V of the left hand in a 53‐year‐old female smoker

Atheromatous embolization

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