No abstract

A young male referred to our hospital with symptoms of febrile illness with development of extensive gangrenous changes in the limbs and extensive purpura of all the limbs. He was found positive for anti hepatitis C antibody. To introspect about etiologies behind the symmetric peripheral gangrene (SPG), work up for cryoglobulins done which was found to be positive. This was suggestive for possibility of catastrophic cryoglobulinemic vasculitis, secondary to hepatitis C with multi organ involvement. He received pulse therapy of steroid and plasmapheresis. During further stay in intensive care unit he developed wet gangrenous changes over all the four limbs with septic shock and underwent bilateral above knee amputation.

A young male patient was referred to our hospital with a diagnosis of cerebral hydatid cyst with recurrent seizures and respiratory failure. Seizures were attributed to hydatid cyst diagnosed on CT Head. After admission and initial stabilisation the sensorium did not improve. Subsequently, he developed hypotension and acute kidney injury requiring vasopressor support and renal replacement therapy. MRI brain was done which showed a large infarct in left middle cerebral artery (MCA) territory. To introspect about etiologies behind the infarct, thrombophilic workup was sent in which anticardiolipin antibodies were elevated suggesting a possibility of underlying catastrophic APLA syndrome (CAPS).