Unusual cutaneous lesions indicating fat embolism syndrome in homozygous sickle cell disease

Bachmeyer, Claude; Lionnet, François; Stojanovic, Katia Stankovic; Moguelet, Philippe; Aractingi, S.

doi:10.1002/ajh.23493

Cited by 1 publication

(1 citation statement)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[6][7][8] The classical triad of this syndrome consists of respiratory distress, unspecific neurological signs such as confusion or a comatose state, and cutaneous petechiae. [9][10][11][12] The most common presenting sign of fat embolism syndrome is an acute respiratory distress, 10 and it was possibly the first clinical feature in our patient. Thrombocytopenia often occurs.…”

Section: Diagnosismentioning

confidence: 99%

Cerebral Fat Embolism in Hemoglobin SC Disease

Scheifer

Lionnet

Bachmeyer

et al. 2017

The American Journal of Medicine

Self Cite

View full text Add to dashboard Cite

A 63-year-old Caribbean man was admitted to the hospital for low back and pelvic pain. His medical history included sickle cell hemoglobin (Hb) C disease with no vasoocclusive crisis within the last 20 years, and chronic obstructive pulmonary disease treated with inhaled corticosteroids for the last 4 years. A few hours after admission, respiratory distress with polypnea occurred, requiring an oxygen flow rate of 12 L per minute. At that time, a thrombocytopenia was detected in peripheral blood, with a platelet count of 112,000/mm 3 , as well as increased hemolysis (LDH 4990 IU/L; normal range 125-250). He was transferred to the Intensive Care Unit. The patient's neurological and respiratory status got worse in the Intensive Care Unit, with agitation, confusion, and hypercapnic acidosis leading to his intubation. Disseminated intravascular coagulation, thrombocytopenia, and leukopenia developed. Chest computed tomography scan showed lung bilateral alveolar condensation in the posterior basal segment and bilateral pleural effusions. A bone marrow smear was performed and showed bone marrow necrosis. The diagnosis of pulmonary infection without bacterial identification was made; the patient required antibiotic therapy combination and blood transfusion. The wake-up after initial sedation was delayed and no real consciousness after 4 days without sedation was detected, therefore leading to further investigations. ASSESSMENT An electroencephalogram, a lumbar puncture, and a cerebral magnetic resonance imaging (MRI) scan were performed: Funding: None.

show abstract