No abstract

Kasabach-Merritt phenomenon (KMP) is consumptive coagulopathy in large vascular lesion. This condition is specific in kaposiform haemangioendothelioma (KHE) and tufted angioma, associated with high mortality rate. This condition often involves the limbs, trunk and retroperitoneum. The clinical features that are usually found are purpura, oedema, induration and ecchymosis. A boy baby aged 9 months presented with a history of violaceous tumour that appeared on his left leg at birth that became enlarged since 6 months ago that caused discrepancy between both of his legs. The patient has his left leg massaged through alternative treatment, causing it became bruised and wounded. Blood examination showed normocytic normochromic anaemia with severe thrombocytopenia and high D-dimer. The patient was diagnosed with KMP with cellulitis and treated with oral corticosteroid, propranolol and antibiotics. Diagnosis of KMP can be made through clinical and laboratory findings. Combination therapy with corticosteroid and propranolol can be considered for KMP treatment.

Background: Ischemic heart disease is one of the interrelated disease amongst cardiovascular disease group. Pathophysiological model of ischemic heart disease and myocardial ischemia are caused by obstructive atherosclerotic plaque, which involves the narrowing of small blood vessels that oxygenate the heart muscle by the build-up of plaque. Diet plays an important role in ischemic heart disease. Copper, an essential trace metal micronutrient, is required for myocardial angiogenesis action. Copper deficiency leads to cardiac mitochondrial structural defect and interference in oxidative phosphorylation. Aims: This study aims to examine the association between blood copper levels amd the incidence of ischemic heart disease. Methods: A total of 30 patients in cardiovascular clinic in Universitas Sumatera Utara Hospital in Medan, Indonesia from September 2021 until January 2022 were included in this cross-sectional study, with descriptive analytics. Demographic data, smoking behavior, supplement consumption, anthropometry measurements, body mass index, medical history were collected. Food frequency questionnaire (semiquantitative FFQ) was used to obtain food recall data. Blood level of copper were analysed in Prodia Clinical Laboratory. Results: Out of 30 patients in this study, 70% were male with a mean age of 60.6 years old. Research subjects who had risk factor of smoking were as much as 33.3%. Comorbidities such as dyslipidemia and diabetes mellitus were apparent, which were 63.3% and 30%, respectively. Sixty percent of the subjects were sedentary with mean body mass index 25.9 kg/m2. Median level of copper consumed daily was 1400 mcg/day and mean blood copper level was 1034,5 mg/L. Based on the blood copper level analysis of the subjects, we found  an insignificant negative correlation between blood copper level with the incidence of ischemic heart disease (r = -0.050; p <0.795). Conclusion: This study found no association between blood copper levels and the incidence of ischemic heart disease.