ABSTRACT
Levetiracetam has not been reported to cause purpura. We report a case of purpura associated with levetiracetam. A 81-year-old man suffered from post-stroke seizure. Seizure was well controlled with valproate. Valproate was discontinued due to pancytopenia and levetiracetam was prescribed when he was admitted with pneumonia. A few days later, he recovered from pancytopenia and pneumonia. However, he was rehospitalized due to multiple variable sized-purpura on the whole body surface without thrombocytopenia. After discontinuing levetiracetam, purpura disappeared.
Subject(s)
Aged, 80 and over , Humans , Pancytopenia , Piracetam , Pneumonia , Purpura , Seizures , Thrombocytopenia , Valproic AcidABSTRACT
Beau's line is a grooved transverse line on the fingernail or toenail, and is considered as a kind of nail disorder, It is known to occur with temporary arrest of nail matrix proliferation. The causes of Beau's line comprise severe systemic illness as well as drug ingestion. A 51-year-old male patient had developed Beau's line on all his fingers after about three months of oxcarbazepine administration. These nail changes disappeared spontaneously with nail growth two months later. The authors report a case of oxcarbazepine induced Beau's line.
Subject(s)
Humans , Male , Middle Aged , Carbamazepine , Eating , Fingers , NailsABSTRACT
Osler-Weber-Rendu disease is characterized by epistaxis, cutaneous telangiectasia, and visceral arteriovenous malformations (AVMs). A 65-year-old male with recurrent epistaxis, old infarction and recent multiple rib fractures caused by a bicycle accident had middle cerebral thromboembolic infarctions when he stopped taking clopidogrel due to massive epistaxis and hemopneumothorax. On examinations, there was no focal cerebral stenosis, but there were telangiectasia, pulmonary and hepatic AVMs. A suspicious Osler-Weber-Rendu disease patient should be evaluated by proper screening and regular follow-up to minimize serious sequelae such as thromboembolic stroke.
Subject(s)
Aged , Humans , Male , Arteriovenous Malformations , Cerebral Infarction , Constriction, Pathologic , Epistaxis , Follow-Up Studies , Hemopneumothorax , Infarction , Infarction, Middle Cerebral Artery , Mass Screening , Middle Cerebral Artery , Rib Fractures , Stroke , TelangiectasisABSTRACT
PURPOSE: Retinal blood vessels and cerebral small vessels possess similar characteristics anatomically, physiologically and embryologically. We studied the availability of abnormal fundus findings of patients who had an atherothrombotic ischemic stroke and who have the risk factors. METHODS: Fundus photographs and brain images were taken in patients who had a first-ever symptomatic ischemic stroke of large artery atherosclerosis (LAA) or small vessel occlusion (SVO) from March 2004 to February 2005. We analyzed the association between fundus abnormalities and ischemic stroke subtypes. RESULTS: Based on brain MRI and MRA, a total of 47 patients were classified into SVO and LAA groups. The SVO group consisted of 27 patients (mean age: 69.7 years), and the LAA group consisted of 20 patients (mean age: 65.4 years). The control group comprised 15 patients (mean age: 64.9 years). The baseline characteristics were similar among the three groups. The severity of the retinal arteriolar narrowing and sclerosis were associated with hypertension. Compared to the control group, both the SVO and LAA groups showed more severe arteriolar sclerosis, the SVO group showed more severe arteriolar narrowing and the LAA group showed more frequent AV crossing and retinal exudate. CONCLUSIONS: Retinal arteriolar abnormalities such as arteriolar narrowing and sclerosis are more severe in atherothrombotic ischemic stroke patients. Indirectly, retinal microvascular changes may indicate the status of the cerebral vasculature. Thus, analysis of fundus findings is useful for predicting an atherothrombotic ischemic stroke and planning follow-up examinations.