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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 331:792-800 September 22, 1994 Number 12
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Case 35-1994— A 55-Year-Old Woman with a Skin Rash and Hemiparesis after Staphylococcal Protein A Column Therapy
Walter H. Dzik, and Lyn M. Duncan

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Presentation of Case

A 55-year-old woman with idiopathic thrombocytopenic purpura was admitted to the hospital because of left hemiparesis.

The patient had been well until 3 1/2 years earlier, when easy bruising developed and a diagnosis of idiopathic thrombocytopenic purpura was made; she had a poor response to prednisone therapy. Six months later she was first seen at this hospital. Physical examination showed petechiae and ecchymoses. Hematologic studies were performed (Table 1). Prednisone (80 mg daily) was begun, and one week later the platelet count was 41,000 per cubic millimeter. A splenectomy was performed one month later at a foreign hospital. . . . [Full Text of this Article]

Differential Diagnosis

Clinical Diagnoses

Dr. Walter H. Dzik's Diagnoses

Pathological Discussion

Anatomical Diagnoses

References



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