Orange-like skin lesion and hypertension—what is the link?
Hello friends, I found it extremely interesting.Try answering it.
A 12-year-old girl was hospitalized in July 2000 for an episode of abdominal pain, vomiting and collapse. Anaemia secondary to acute upper gastrointestinal haemorrhage was diagnosed; however, the reason for the haemorrhage could not be identified. Physical examination revealed normal growth, and hypertension of 180/110 mmHg. Thickened yellowish skin (peau d’orange) was noticed in the axilar and inguinal regions and on the abdominal wall . Femoral pulse was palpable. Laboratory tests revealed: haemoglobin 8.1 g/dl, haematocrit 0.20, white blood cell count 11.2 × 109, platelets 230 × 109, erythrocyte sedimentation rate 5/10, and C-reactive protein <4.91 g/l. Urinalysis was within normal limits on several occasions. Serum electrolytes, liver enzymes and kidney function tests were within normal limits. In order to assess the cause of hypertension, the following tests were performed, with normal results: urine catecholamine levels, urine vanilmandelic acid levels, cortisol, adrenocorticotrophic hormone (ACTH), 17 (OH) and progesterone. Aldosterone was 66 μg/24 h, and plasma renin activity (PRA) was 5.18 ng/ml/h (normal 0.98–4.1). Fundus examination revealed angioid streaks radiating outwards from the peripapillary area bilaterally. Fluorescein angiography was not done (unavailable in our centre). Abdominal ultrasound showed normal liver, spleen, kidneys, pancreas and blood vessels. Suprarenal glands were normal. Doppler studies of aorta, renal arteries, hepatic artery and splenic artery were also normal. Tc99m DMSA scintigraphy, IVP and renal angiography (selective right and left renal arteriography and aortography) were without abnormalities. The electrocardiogram at rest and post-exercise was normal. Echocardiography showed a slight prolapsus of the mitral valve and mild intraventricular septal hypertrophy. There were no signs of aortal coarctation. Renal ultrasonography performed after 6 months showed a characteristic pattern of dotted increased echogenicity at the corticomedullary junction (medullar hyperechogenicity)
.What is your diagnosis?
.What is your diagnosis?
gastric cancer bcoz of haemorraage peud orange metastasis is done might also has pheochromocytoma
ReplyDeleteGood try Mr.Vara prasad but there is one diagnosis, not more than one like gastric cancer +phaeochromocytoma etc. Please try again, i appreciate your diagnosis. All i am saying is there is a better diagnosis.
ReplyDeleteit must be pseudoxanthoma elasticum, am i right??
ReplyDelete@dr.varun Patel:- yes it is!
ReplyDelete