Deep Vein Thrombosis Caused Pulmonary Embolism with the Cutaneous Presentation of Petechia and Purpura: A Case Report

深部靜脈栓塞引發肺栓塞之皮膚以瘀點紫斑表現：個案報告

王業亨(Yeh-Heng Wang) ； 高正國(Cheng-Kuo Kao) ； 林宗興(Tsung-Hsing Lin) ； 許宗鴻(Choon-Hoon Hii) ； 阮祺文(Chi-Wen Juan)

《弘光學報》 84期 (2019/09) Pp. 35-40

https://doi.org/10.6615/HAR.201909_(84).0003

摘要

Pulmonary embolism is a common and sometimes fatal form of venous thromboembolism. The diagnosis of pulmonary embolism can often be challenging due to its variable and nonspecific clinical presentation. Dyspnea, chest pain, fainting (or syncope), and hemoptysis are the classical presentations. In some rare instances, the cutaneous presentation of petechia and purpura would appear. Petechiae appear when capillaries bleed, leaking blood into the skin. A combination of the respiratory and cutaneous presentation is rare, and only a few were reported in the past. This report presents a rare case of deep vein thrombosis that caused pulmonary embolism with the cutaneous presentation of petechia and purpura.

關鍵字

Deep vein thrombosis ； Pulmonary embolism ； Petechia ； Purpura

並列摘要

肺栓塞是一種常為致命性的靜脈血栓栓塞形態。因為臨床表現的多樣化以及不明確性，經常會使得臨床診斷變的具有困難度。呼吸困難，胸痛，昏厥以及咳血是比較典型的臨床表現。在相較罕見的狀況下，皮膚的表現如瘀點與紫斑會一併出現。然而瘀點的出現則通常是由微血管流血，滲出至皮膚。綜合呼吸症狀與皮膚症狀的同時出現的案例很罕見，在過去只有少數報告案例。本案例報告正是深部靜脈栓塞引發肺栓塞之皮膚表現如瘀點和紫斑的同時出現的一個少見案例。

並列關鍵字

深部靜脈栓塞 ； 肺栓塞 ； 瘀點 ； 紫斑

參考文獻

Experimental and clinical cardiology 2013, 18(2), 129–138.

Coon WW, Willis PW. Deep venous thrombosis and pulmonary embolism: prediction, prevention and treatment. Am J Cardiol 1959; 4:611-21.

Dickson BC. Venous thrombosis: on the history of Virchow's triad. Univ Toronto Med J 2004; 81:166-171.

Bagot CN, Arya R. Virchow and his triad: a question of attribution. Br J Haematology 2008; 143(2):180-90.

Gohil R, Peck G, Sharma P. The genetics of venous thromboembolism. A meta-analysis involving approximately 120,000 cases and 180,000 controls. Thromb Haemost 2009; 102:360-70.