Sneddon's syndrome presenting with neuropathic pain.

[sneddon syndrome]

A 55 -year -old man was admitted to us with a sense of numbness , tingling , and burning in his feet and headache , characterized as a feeling of pressure all around his head , for 1 year and aggravated in the past 3 months . The patient 's neurologic examination was normal and he had no other known diseases except for hypertension according to his medical history . During the examination , we recognized purplish lesions on the patient 's body . His kidney , liver , and thyroid function test results and vitamin B 12 levels were all normal . His hematocrit level was 41 .8 %, platelet value was 234 ,000 (150 ,000 -500 ,000 ); and sedimentation rate was 9 mm /h (0 -20 ). Electromyography was performed and results were found to be normal . The patient was diagnosed as having small fiber neuropathy . Dermatologic examination revealed reddish blue mottling of the skin with fishnet reticular pattern on his back , on the front side of the body , and on both arms and legs , and the lesions were classified as livedo racemosa (Figure 1 ). Brain magnetic resonance imaging (MRI ) showed subcortical hyperintense ischemic-gliotic signal changes on T 2 -FLAIR in the deep white matter of bilateral frontoparietal vertex , centrum semiovale , and corona radiata (Figure 2 ). FLAIR sequence axial MRI of the brain of our patient showed subcortical hyperintense lesions in both cerebral hemispheres . His cardiac examination was normal and minimal aortic regurgitation was seen on echocardiography . His cognitive assessment Minimental Test Score was 22 , and Montreal Cognitive Assessment score was 18 . Laboratory values for inflammatory markers and autoimmune antibodies including syphilis serology , lupus anticoagulants , and anticardiolipin antibodies were negative . Factor V Leiden mutation was not detected in the patient . The patient was diagnosed with Sneddon 's syndrome with the above signs and symptoms and small fiber neuropathy . Clopidogrel 75 mg and gabapentin 1200 mg was started once a day and blood pressure regulation was achieved .

Diseases
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Diseases presenting "autoimmune antibodies including syphilis serology" symptom

sneddon syndrome

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