Subject(s)
Antivenins/therapeutic use , Daboia , Immunologic Factors/therapeutic use , Snake Bites/complications , Venous Thrombosis/etiology , Viper Venoms , Adult , Animals , Blepharoptosis/etiology , Brain Infarction/etiology , Female , Hematuria/etiology , Humans , Snake Bites/diagnosis , Snake Bites/therapy , Venous Thrombosis/complicationsABSTRACT
Pyoderma gangrenosum is an uncommon ulcerative cutaneous neutrophilic dermatosis. In about 50 percent of cases, it is associated with systemic diseases like inflammatory bowel disease, rheumatoid arthritis, systemic lupus erythromatosus, hematological diseases and various malignancies. There is no specific laboratory finding or histological features pathognomonic of pyoderma gangrenosum and it is often a diagnosis of exclusion. Here, we report an elderly female without history of any systemic disorders, presenting to us with extensive, bilaterally symmetrical, deep leg ulcers along with multiple superficial ulcers involving the right groin which was diagnosed as pyoderma gangrenosum. The only positive rheumatologic marker was serum anti-cyclic cittrulinated peptide2 antibody, which was found to be strongly positive. Dramatic response to systemic corticosteroid followed by successful split skin grafting was observed in our patient.
Subject(s)
Antibodies/blood , Pyoderma Gangrenosum/blood , Anti-Inflammatory Agents/therapeutic use , Biomarkers/blood , Female , Humans , Middle Aged , Prednisolone/therapeutic use , Pyoderma Gangrenosum/drug therapy , Pyoderma Gangrenosum/surgery , Skin TransplantationABSTRACT
Portal vein thrombosis (PVT) is a rare disorder that is associated with a variety of underlying condition of which liver cirrhosis, malignancy and myeloproliferative disorders are the most common. It is of two types, acute and chronic portal vein thrombosis. Anticoagulation therapy is recommended for all patients with acute portal vein thrombosis. Chronic portal vein thrombosis is characterised by the development o f portal hypertension. Bleeding from ruptured varices is the main complication. In the absence of bleeding, continuous anticoagulation therapy should be considered for chronic portal vein thrombosis in whom an underlying prothrombotic factor is to be identified. Here in this report a 13-year-old girl presented with haematemesis. The spleen was hugely enlarged. Her Hb was 8.38 g/dl. Grade III oesophageal varices were found in oesophagogastroduodenostomy. CT abdomen showed portal cavernoma formation with increased splenic collateral. Protein C activity was 45% and protein S activity was 40%. She was treated with beta-blocker, endoscopic variceal ligation followed by low molecular weight heparin and warfarin.
