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Palpable Purpura in an Elderly Man—Quiz Case
Timothy K. Chartier, MD;
Richard A. Johnson, MD;
Michael Kaminer, MD;
Steven Tahan, MD
Harvard Medical School, Boston, Mass (Drs Chartier, Johnson, Kaminer, and Tahan), and University of Connecticut Health Center, Farmington (Dr Chartier)
Arch Dermatol. 2003;139:1363-1368.
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REPORT OF A CASE
A 74-year-old man with a history of vitamin B12 deficiency and alcoholism presented with a 2-week history of increasing fatigue associated with difficulty in ambulating because of swelling and pain in his left foot and ankle. Over the ensuing 1 weeks, his foot and ankle became more tender, swollen, and erythematous, and on follow-up examination he was noted to have palpable purpura of both legs.
The findings of laboratory evaluation were remarkable for normocytic anemia (hematocrit, 29.1% [reference range (RR), 40%-52%]); mild renal insufficiency (serum urea nitrogen, 27 mg/dL [9.6 mmol/L] [RR, 6-20 mg/dL (2.1-7.1 mmol/L)]; creatinine, 1.3 mg/dL [115 µmol/L] [RR, 0-1.3 mg/dL (0-115 µmol/L)]) with hematuria and an elevated erythrocyte sedimentation rate (53 mm/h [RR, 0-15 mm/h]). The results of other laboratory studies, including liver function tests, electrolyte levels, white blood cell count with . . . [Full Text of this Article]
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Arch Dermatol. 2003;139(10):1363-1368.
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