Clin Med
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Case Reports
Lesson of the month 1: sudden onset postural livedo reticularis, cyanotic toes and multiorgan failure.
Cholesterol embolisation syndrome (CES) is a rare but serious disease with high mortality caused by the formation of an embolus made up of cholesterol crystals from atherosclerotic plaques. Its clinical presentation is usually initially insidious and it often remains unrecognised because of its non-specific clinical presentation, which can cause delays in treatment and high mortality. The most common physical symptoms are cutaneous. We present a lethal case of CES to increase the awareness about this serious condition.
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The clotting screen is an 'integral' part of the routine blood tests in most medical wards. It is likely that only with the increasing requests for prothrombin time and activated partial thromboplastin time are abnormal results noted. ⋯ Due to variable understanding of this complex system, many misconceptions have arisen in relation to the clinical effects expected from abnormal clotting screens. Some of these are discussed with considerations of appropriate management in those situations.