Ischemic Limb Gangrene with Pulses

Retiform purpura and ischemic limb gangrene with pulses

“…Therefore, it is critical to recognize this disorder early and provide immediate management. Ischemic limb gangrene with pulses can result from DIC, calciphylaxis, and atheroembolism [1,2]. In our case, the focal facial skin infection was very likely the cause of the toxic shock syndrome (TSS) and the resultant DIC, which subsequently led to shock, microvascular thrombi in various organs, retiform purpura, and dry gangrene in the limbs [3,4].…”

Heparininduzierte Thrombozytopenie

“…Sie hemmen auch die Carboxylierung von Protein C. Durch die massive prothrombotische Gerinnungssituation in der akuten HIT führt der durch VKA verursachte zusätzliche funktionelle Protein-C-Mangel zu Thrombosen in der Mikrozirkulation. Die häufigste Ursache für den Verlust einer Extremität als Komplikation der HIT sind der zu frühe Beginn mit VKA und eine daraus resultierende Phlegmasia coerulea dolens [26]. Wurde einem Patienten mit akuter HIT bereits ein VKA gegeben, sollte dieser sofort abgesetzt und Vitamin K i. v. substituiert werden.…”

Heparin-induced thrombocytopenia

“…However, in recent years, the marked hypercoagulability of HIT has been appreciated, including its association with DIC [4,5,6 && ,15]. Although 10-20% of patients with HIT have overt DIC, probably DIC exists in most patients, as even normal fibrinogen levels are relatively low for the patient's usual postoperative state.…”

“…6HIT) DIC, called 'acute DIC/hepatic necrosis-limb necrosis syndrome', has been linked to acral limb ischemic necrosis in patients with septic shock or cardiogenic shock[6 …”