A rare clinical picture: Blue toe syndrome

Öz

Blue toe syndrome is a clinical condition characterized by pain and cyanosis in one or more toesor soles of the feet due to microvascular occlusion. The most common cause is atheroembolicdisease or aneurysm. Embolization occurs typically from an ulcerated atherosclerotic plaqueor aneurysm located in the aorto-iliac artery and femoral arteries. Dianosing and treating thesource of embolism in a patient with blue toe syndrome is very important in order to preventrecurrent embolism that may result in limb loss and / or death. On the other hand, palpableperipheral pulses in the first physical examination performed on a patient presenting with theabove-mentioned clinical symptoms excludes vascular pathologies, which may lead to delayin diagnosis. Suspecting microvascular occlusion and using imaging methods to diagnoseintravascular pathologies are quite important in these patients. In our case, there was painand blue / purple discoloration on the soles of both feet, which was aggravated by walking.Peripheral pulses were palpable on physical examination. When CT angiography images andbiopsy results from existing lesions were evaluated in the light of clinical findings, a diagnosis ofblue toe syndrome was made.

Anahtar Kelimeler

• Blue toe syndrome
• atheroembolism
• microvascular
• occlusion

Nadir görülen bir klinik tablo: Blue toe sendromu

Öz

Blue toe sendromu; mikrovasküler oklüzyona bağlı bir veya daha fazla ayak parmağında veya ayak tabanında ağrı ve siyanoz ile karakterize klinik durumdur. En sık nedeni ateroembolik hastalıklar veya anevrizmadır. Embolizasyon genellikle aorto-iliak, femoral arterlerde bulunan ülsere aterosklerotik plaktan veya anevrizmadan meydana gelir. Blue toe sendromu gelişen bir hastada emboli kaynağını tespit ve tedavi etmek, uzuv kaybı ve/veya ölüm ile sonuçlanabilecek tekrarlayan embolileri önlemek adına oldukça önemlidir. Bununla birlikte yukarıda belirtilen klinik semptomlarla başvuran hastada yapılan ilk fizik muayenede periferik nabızların palpabl olması klinisyenleri vasküler patolojilerden uzaklaştırmakta, buna bağlı tanı koymada gecikme söz konusu olabilmektedir. Bu hastalarda mikrovasküler oklüzyondan şüphelenilmesi ve damar içi patolojileri teşhis için görüntüleme yöntemlerine başvurulması hayati önem arz etmektedir.

Anahtar Kelimeler

• mavi ayak baş parmağı sendromu
• ateroembolizm
• mikrovasküler
• oklüzyon

Kaynakça

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