Rumpel-Leede phenomenon in a patient with adult-onset Still's disease

Abstract

Rumpel-Leede phenomenon (RLP), also known as acute capillary rupture syndrome (ACRS), is a rare occurrence where distal dermal capillaries rupture in response to a proximal compressive force, such as a blood pressure cuff or tourniquet. This phenomenon has been reported to occur in states of vascular fragility such as long-term steroid use, hypertension or diabetes mellitus. Here, we provide a report of RLP occurring secondary to tourniquet application in a 26-year-old woman with adult-onset Still's disease (AOSD) and a recent drug rash. In this case, the cause of the phenomenon is most likely multifactorial. Likely contributing factors include long-term steroid use for the treatment of AOSD, and increased vascular permeability secondary to the drug rash. Patients and clinicians should be aware that the treatment of AOSD may induce a state of capillary fragility and they should work together to minimise the risk of complications.

Biceps muscle injury associated with non-invasive automatic blood pressure monitoring

“…There are no case reports in the literature surrounding biceps muscle strain or injury associated with use of a blood pressure cuff. Blood pressure cuff inflation in NIBP monitoring has been associated with three reported cases of the Rumpel-Leede sign, a petechial purpuric skin rash on the limb where the cuff was applied, secondary to acute dermis capillary rupture 12–14. There are two case reports of compartment syndrome due to excessive blood pressure cuff cycling, excessive pressure and improper cuff positioning 15 16.…”

Rumpel-Leede Phenomenon Associated with Pneumatic Compression: A Case Report

“…The sphygmomanometer was the most commonly used device. 15–19 Others included the tourniquet, 8 radial arterial wristband, 12 peritoneal insufflation during laparoscopic abdominal surgery, 13 knee stocking, 21 cloth material, 22 and car seat. 23 Regarding comorbidities, diabetes mellitus, hypertension, and thrombocytopenia are frequently reported.…”

“…Several predisposing factors, including thrombocytopenia, increased capillary fragility or permeability, diabetes mellitus, diabetes insipidus, hypertension, chronic renal failure, and use of antiplatelets or anticoagulants, have been demonstrated to be associated with this condition. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Here, we present the Rumpel-Leede phenomenon following prolonged use of pneumatic compression in a patient without underlying diseases who underwent en bloc spondylectomy for a giant cell tumor of the spine and developed sepsis.…”

Rumple-Leede phenomenon after tourniquet application in acute hand surgery: a case report

“…Although the tourniquet time in this patient was over 1 hour, it was unlikely to be the cause of his RLP. There had been no reported correlation between the duration of tourniquet time and RLP, as it can occur even after a minute of cuff inflation (Lambdin and McKenzie, 2017).…”