Korean Journal of Nephrology 2010;29(4):501-503.
Acute Dermal Capillary Rupture in a Patient with Diabetic Nephropathy
Hea Min Yu, M.D., Hae Eun Yun, M.D., Young Ha Baek, M.D, Hyung Ku Chon, M.D., Kyung Taek Park, M.D., Dae Seon Ahn, M.D., Kyung Pyo Kang, M.D., Won Kim, M.D., Sung Kwang Park, M.D. and Sik Lee, M.D.
Department of Internal Medicine, Research Institute of Clinical Medicine Chonbuk National University Medical School, Jeonju, Republic of Korea
증례 : 당뇨병성 신장병증을 가진 환자에서 급성 진피 내 모세혈관 파열
유혜민, 윤해은, 백영하, 전형구, 박경택, 안대선, 강경표, 김 원, 박성광, 이 식
전북대학교 의학전문대학원 내과학교실
A 46-year-old diabetic woman visited our hospital with generalized edema and high blood pressure. An appropriately sized noninvasive blood pressure cuff was placed on her right arm above the elbow to measure blood pressure. While we were checking her blood pressure, we noticed small red petechial spots distal to the cuff involving her entire right forearm. Her blood pressure was 170/96 mmHg. The laboratory findings showed no abnormality of anticoagulation. The rest of the patient’s extremities were not affected. The petechiae on the right arm resolved spontaneously after ten days. The most likely explanation for these petechiae is acute dermal capillaryrupture, which is called the Rumpel-Leede phenomenon. Acute dermal capillary rupture appears as petechiae in an area following application of vascular constriction such as application of tourniquet to draw blood specimen or use of blood pressure cuff due to capillary fragility or abnormal platelets in numbers or in function. This situation has been reported previously in the literature as the Rumpel-Leede phenomenon in association with prolonged noninvasive BP monitoring. In the patient described herein, increased venous pressure from blood pressure measurement and capillary fragility associated with diabetes mellitus may have increased the risk of acute dermal capillary rupture.
Key Words: Capillary fragility, Diabetic nephropathy, Blood pressure

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