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Hematologist identifies different limb loss syndromes

Various causes such as septic shock are indicated

Date:
August 12, 2015
Source:
McMaster University
Summary:
How people can develop limb gangrene and lose fingers and feet has baffled doctors for centuries. Now a hematologist has identified different limb loss syndromes along with explanations for what is happening and what can be done about it.
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How people can develop limb gangrene and lose fingers and feet has baffled doctors for centuries.

Now a McMaster University hematologist has identified different limb loss syndromes along with explanations for what is happening and what can be done about it.

In a review published by the New England Journal of Medicine, Dr. Ted Warkentin says these rare but devastating conditions can be the result of microthrombosis, or blood clots in the smallest blood vessels. He has identified various causes such as septic shock, some cancers, and side effects of certain blood thinners.

"This is a new idea, but important because these conditions can be devastating. Some of the athletes of the current Parapan Am Games are disabled because of these medical conditions," said Warkentin, a professor of medicine and of pathology and molecular medicine for the Michael G. DeGroote School of Medicine at McMaster. He is also a hematologist for Hamilton Health Sciences.

He looked into the syndrome called "symmetric peripheral gangrene" which can kill the extremities, including both the feet and hands, and sometimes other areas such as nose or ears. These patients often have underlying septic shock caused by blood poisoning, but it is failure of the liver to produce factors that protect the small blood vessels, such as "protein C," that has been identified as a risk factor for the limb gangrene.

The treatment for symmetric peripheral gangrene is the blood thinner, heparin, as well as replacement of the missing protective factors through use of blood plasma.

Warkentin also looked into the syndrome of "venous limb gangrene," which is the rare situation of limb loss that occurs in a patient with blood clots in a larger limb vein (called "deep vein thrombosis" or DVT). Here, he identified side effects of blood thinners, such as heparin and warfarin, as well as advanced cancer, as possible causes. These patients were also found to have critically low levels of protein C.

"By closely examining this group of rare and poorly understood syndromes, we can identify certain unifying themes, and get closer to having a rational approach to treating these conditions," said Warkentin.


Story Source:

Materials provided by McMaster University. Note: Content may be edited for style and length.


Journal Reference:

  1. Dan L. Longo, Theodore E. Warkentin. Ischemic Limb Gangrene with Pulses. New England Journal of Medicine, 2015; 373 (7): 642 DOI: 10.1056/NEJMra1316259

Cite This Page:

McMaster University. "Hematologist identifies different limb loss syndromes: Various causes such as septic shock are indicated." ScienceDaily. ScienceDaily, 12 August 2015. <www.sciencedaily.com/releases/2015/08/150812200427.htm>.
McMaster University. (2015, August 12). Hematologist identifies different limb loss syndromes: Various causes such as septic shock are indicated. ScienceDaily. Retrieved May 25, 2017 from www.sciencedaily.com/releases/2015/08/150812200427.htm
McMaster University. "Hematologist identifies different limb loss syndromes: Various causes such as septic shock are indicated." ScienceDaily. www.sciencedaily.com/releases/2015/08/150812200427.htm (accessed May 25, 2017).

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