651
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Muñiz Díaz E. [Platelet antigens, antibodies and related clinical conditions]. SANGRE 1991; 36:395-415. [PMID: 1840085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
MESH Headings
- Absorption
- Adult
- Animals
- Antibodies, Monoclonal/immunology
- Antigens, Human Platelet/classification
- Antigens, Human Platelet/genetics
- Antigens, Human Platelet/immunology
- Autoantibodies/immunology
- Autoantigens/immunology
- Autoimmune Diseases/immunology
- Blood Platelets/immunology
- Child
- Female
- Gene Frequency
- Haptens
- Humans
- Immune Complex Diseases/immunology
- Immunity, Maternally-Acquired
- Incidence
- Infant, Newborn
- Isoantibodies/immunology
- Isoantigens/immunology
- Platelet Membrane Glycoproteins/genetics
- Platelet Membrane Glycoproteins/immunology
- Platelet Transfusion
- Pregnancy
- Purpura/etiology
- Purpura/immunology
- Purpura, Thrombocytopenic, Idiopathic/immunology
- Purpura, Thrombocytopenic, Idiopathic/therapy
- Thrombocytopenia/chemically induced
- Thrombocytopenia/epidemiology
- Thrombocytopenia/immunology
- Transfusion Reaction
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652
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Ratnam KV, Su WP, Peters MS. Purpura simplex (inflammatory purpura without vasculitis): a clinicopathologic study of 174 cases. J Am Acad Dermatol 1991; 25:642-7. [PMID: 1791222 DOI: 10.1016/0190-9622(91)70246-x] [Citation(s) in RCA: 88] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Purpura simplex manifests clinically as macular purpuric and petechial pigmented, golden, annular, or lichenoid lesions. These subtypes have been termed Schamberg's purpura, lichen aureus, Majocchi's purpura, and Gougerot-Blum purpura. Histologically, there is inflammation and hemorrhage without fibrinoid necrosis of vessels. One hundred seventy-four cases were retrospectively reviewed. In some patients, the eruption was related to medications. Treatment was usually of limited benefit. Fifty-eight of 87 patients (67%) who had follow-up data did eventually have clearing of lesions. Because of the clinical and histologic similarities among the subtypes, the inclusive term purpura simplex is favored.
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653
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Kullberg BJ, Westendorp RG, van 't Wout JW, Meinders AE. Purpura fulminans and symmetrical peripheral gangrene caused by Capnocytophaga canimorsus (formerly DF-2) septicemia--a complication of dog bite. Medicine (Baltimore) 1991; 70:287-92. [PMID: 1921703 DOI: 10.1097/00005792-199109000-00001] [Citation(s) in RCA: 99] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
We review the syndrome of Capnocytophaga canimorsus (DF-2) septicemia after exposure to dogs or cats. We describe a previously healthy patient who developed diffuse intravascular coagulation and symmetrical peripheral gangrene as a result of C. canimorsus septicemia after a dog bite. To our knowledge, this patient was the first to receive combined plasmapheresis and leukapheresis for C. canimorsus septicemia. Symmetrical peripheral gangrene is frequently associated with C. canimorsus septicemia and may lead to an early diagnosis in patients who become severely ill after a dog bite. Other complications include arthritis, meningitis, and endocarditis. These manifestations can also be found in previously healthy patients, although a prior splenectomy or other causes of impaired host defense clearly enhance the risk. Prompt treatment with penicillin G is required.
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654
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Gamba G, Montani N, Montecucco CM, Caporali R, Ascari E. Purpura fulminans as clinical manifestation of atypical SLE with antiphospholipid antibodies: a case report. Haematologica 1991; 76:426-8. [PMID: 1806449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Purpura Fulminans and DIC were the main clinical manifestations of the antiphospholipid syndrome observed in a 62-year-old man. The patient was well until 44 years of age when he began to suffer from recurrent thrombophlebitis, without other symptoms suggestive of immune disease. At the time of hospital admission the pt. appeared acutely ill, showing high fever, severe anemia, massive urinary blood loss, multiple purpuric patches evolving to hemorrhagic bullae and gangrene rapidly spreading over about 30% of the total body area. No signs of neurological involvement or of visceral thrombotic occlusions were present. Clotting tests were consistent with a diagnosis of DIC, further confirmed by skin biopsy showing the presence of thrombi in dermal arterioles. The autoantibody research was positive as follows: Waaler-Rose 1:40, Anti-DNA 1:80; ANF 1:640, aCA IgG 100 GPL. LA was diagnosed according to standard criteria: prolonged KCT and RVVT not corrected by a mixture of normal plasma and abnormal TTI. Plasma exchange in association with heparin and prednisone was effective in arresting the progression of the skin lesion; nevertheless the patient died ten days after hospital admission for sepsi and acute renal failure.
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655
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Heath SE, Geor RJ, Tabel H, McIntosh K. Unusual patterns of serum antibodies to Streptococcus equi in two horses with purpura hemorrhagica. J Vet Intern Med 1991; 5:263-7. [PMID: 1748978 DOI: 10.1111/j.1939-1676.1991.tb03132.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
An enzyme-linked immunosorbent assay (ELISA) was developed for use in horses to determine serum titers of antibodies of the immunoglobulin classes IgA, IgG, and IgM to Streptococcus equi M-like protein and culture supernatant protein antigens. Serum antibodies were determined in 28 adult horses, including 9 horses with recent S. equi infections, 17 horses without known exposure to S. equi, but without a history of respiratory disease in the preceding 4 months, and 2 horses with clinical purpura hemorrhagica. Serum IgA titers to culture supernatant protein antigen were highest in recently infected horses (P less than 0.001). Serial determinations of antibody titers in the horses with purpura showed that IgG antibodies to both S. equi M-like protein and culture supernatant protein antigens were undetectable initially, but later rose coincidental with clinical recovery from the disease. Possible mechanisms for these findings are discussed.
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656
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Pohl C, Pollok M, Franzen D, Gause A, Diehl V. [Type II mixed cryoglobulinemia in chronic hepatitis]. MEDIZINISCHE KLINIK (MUNICH, GERMANY : 1983) 1991; 86:410-3. [PMID: 1921908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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657
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Porcel JM, Castro A, Pedrol M, Selva A. [Severe thrombocytopenia: a rare complication of infectious mononucleosis]. ANALES DE MEDICINA INTERNA (MADRID, SPAIN : 1984) 1991; 8:413. [PMID: 1768755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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658
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Wohlgethan JR, Stilmant MM, Smith HR. Palpable purpura and uveitis precipitated by splenectomy in an atypical case of Cogan's syndrome. J Rheumatol 1991; 18:1100-3. [PMID: 1920316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A patient with a baffling multisystem illness developed uveitis and palpable purpura shortly after a splenectomy, leading to the diagnosis of vasculitis. Clearance by the mononuclear phagocyte system is a key factor determining the pathogenicity of circulating immune complexes, which are known to be the cause of some forms of vasculitis. The sudden appearance of uveitis and cutaneous vasculitis in an illness of many years' duration was probably a direct result of removal of the spleen.
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659
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Puig N, Sayas MJ, Montoro JA, Villalba JV, Pla A. Post-transfusion purpura as the main manifestation of a trilineal transfusion reaction, responsive to steroids: flow-cytometric investigation of granulocyte and platelet antibodies. Ann Hematol 1991; 62:232-4. [PMID: 1854887 DOI: 10.1007/bf01729839] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We report a typical case of post-transfusion purpura (PTP) due to anti-PlA1 in a 65-year-old woman. Serological studies were carried out using flow cytometry (FCM). The patient also developed red cell alloantibodies that produced a delayed hemolytic transfusion reaction (DHTR) and broad HLA antibodies. Treatment with high-dose intravenous IgG (HDIgG; a first-generation preparation) was ineffective, but a course of steroids resulted in a rapid increase in the the platelet count.
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660
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Bielory L, Fisher AM, Lyons MM, Holland CL. Palpable purpura in a splenectomized patient with a streptococcal infection. ANNALS OF ALLERGY 1991; 66:459-63. [PMID: 1675556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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661
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Cabrera VP, Rodu B. Differential diagnosis of oral mucosal petechial hemorrhages. COMPENDIUM (NEWTOWN, PA.) 1991; 12:418, 420, 422 passim. [PMID: 1933990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Petechiae are pinpoint hemorrhages that occur in subcutaneous or submucosal tissues in a wide variety of conditions. Because of their diversity, the differential diagnosis of oral mucosal petechial hemorrhages is complex. The authors report a case of palatal petechial hemorrhages secondary to episodes of intense vomiting. A review of the many disorders underlying petechial hemorrhages is based on etiologic factors including trauma, platelet abnormalities, clotting factor deficiencies, and defects in vascular integrity.
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662
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663
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Lynn NJ, Pauly TH, Desai NS. Purpura fulminans in three cases of early-onset neonatal group B streptococcal meningitis. J Perinatol 1991; 11:144-6. [PMID: 1890473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The diagnosis of purpura fulminans was associated with three cases of early-onset group B beta-hemolytic streptococcal (GBS) disease. All three infants had confirmed bacterial disease, extensive purpuric lesions involving the extremities, and laboratory evidence of a consumptive coagulopathy. All three children survived but had markedly compromised neurologic outcomes. Purpura fulminans has not been previously reported with early-onset GBS disease.
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664
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Bertolino G, Noris P, Balduini CL. Qualitative and quantitative platelet defect with bleeding symptoms as presenting feature of non Hodgkin lymphomas. Haematologica 1991; 76:243-4. [PMID: 1720756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
A young man with bleeding symptoms, mild thrombocytopenia and abundant marrow megakaryocytes was classified as having idiopathic thrombocytopenic purpura. Neither prednisone therapy nor splenectomy modified the clinical picture. Subsequently, a severe defect of platelet aggregation and release reaction was demonstrated. Fifteen months after the onset of bleeding symptoms, fever and hepatomegaly appeared and the diagnosis of T cell non Hodgkin lymphoma was made on the basis of a histologic review of paraffin sections of the spleen. Chemotherapy induced remission of the lymphoma, disappearance of bleeding symptoms and normalization of the platelet count and function.
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665
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Livneh A, Sharma K, Sewell KL, Keiser HD. Multisystem disease in post-streptococcal arthritis. Ann Rheum Dis 1991; 50:328-9. [PMID: 2042990 PMCID: PMC1004421 DOI: 10.1136/ard.50.5.328] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The case presented is of a patient with migratory polyarthritis and serological evidence of a recent streptococcal infection, consistent with the diagnosis of acute rheumatic fever, who in addition had multisystem disease manifestations. This case supports the concept that the sequelae of streptococcal infection can encompass a broader clinical spectrum than is suggested by the Jones criteria for the diagnosis of acute rheumatic fever.
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666
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Oteo JA, Smersu E, Parras F. [Fulminating purpura and staphylococcal sepsis]. Enferm Infecc Microbiol Clin 1991; 9:256-7. [PMID: 1863630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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667
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Sato K, Tsujimura M, Kitano Y, Yoshikawa K. Purpura caused by UV-irradiation at 375 nm in a patient with hydroa vacciniforme. Br J Dermatol 1991; 124:396-7. [PMID: 2025569 DOI: 10.1111/j.1365-2133.1991.tb00613.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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668
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Kato N, Morioka T. Purpura fulminans secondary to Xanthomonas maltophilia sepsis in an adult with aplastic anemia. J Dermatol 1991; 18:225-9. [PMID: 1918597 DOI: 10.1111/j.1346-8138.1991.tb03072.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Purpura fulminans is a rare disease characterized by purpura ecchymosis, hypotension, and fever associated with disseminated intravascular coagulation. It often begins as a benign infectious process and subsequently progresses to a severe, catastrophic outcome. It is recognized to originate from congenital or acquired protein C deficiency. We present an unusual case of an adult with Xanthomonas maltophilia sepsis that subsequently developed into purpura fulminans with involvement of the four extremities. We discuss the importance of the protein C system in coagulation homeostasis and its relationship to purpura fulminans.
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669
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Martínez de la Iglesia J, Montero Pérez FJ, Díaz Morant V. [Petechiae in meningococcal disease]. Med Clin (Barc) 1991; 96:357-8. [PMID: 2046451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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670
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ter Borg EJ, Van Rijswijk MH, Kallenberg CG. Transient arthritis with positive tests for rheumatoid factor as presenting sign of shunt nephritis. Ann Rheum Dis 1991; 50:182-3. [PMID: 2015013 PMCID: PMC1004371 DOI: 10.1136/ard.50.3.182] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Shunt nephritis is a rare complication of a chronically infected ventriculoatrial shunt. A 17 year old boy is described, with arthritis in both ankles and positive rheumatoid factor tests, who presented with symptoms of shunt nephritis. Blood cultures were positive for Staphylococcus epidermidis. The patient recovered completely after removal of the shunt and antibiotic treatment. Shunt nephritis should be considered in patients with a ventriculoatrial shunt presenting with arthritis, and the arthritis may be an early indicator of an infected ventriculoatrial shunt.
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671
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Godeau B, Fromont P, Bettaieb A, Beaujean F, Duedari N, Bierling P. Relapse of posttransfusion purpura after transfusion with frozen-thawed red cells. Transfusion 1991; 31:189-90. [PMID: 1996488 DOI: 10.1046/j.1537-2995.1991.31291142955.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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672
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Tillant D, Albanèse J, Tomachot L, Durbec O, Granthil C. [Purpura fulminans and C7 deficiency complicated by Pneumocystis carinii pneumonia]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 1991; 10:394-7. [PMID: 1681768 DOI: 10.1016/s0750-7658(05)80816-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
A case of meningococcal purpura fulminans is reported in a 22-year-old woman who also suffered from a congenital deficiency in the seventh component of the complement system. This was her third episode of recurrent meningitis. In the course of her treatment in intensive care, the septic shock was cured, but she developed Pneumocystis carinii pneumonia. Histological investigations revealed abnormalities in her T-cell population, with a very low T-helper (CD4) to T-suppressor (CD8) ratio. Laboratory data showed that she did not have any antibodies to HIV.
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673
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Bair JS, Wu YC, Lü YC. Cryofibrinogenemia: report of a case. J Formos Med Assoc 1991; 90:99-104. [PMID: 1679117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Cryofibrinogenemia, a rare disease, is diagnosed by the presence of reversible cryoprecipitate in plasma, which may cause various clinical manifestations of thromboembolic or hemorrhagic disorders. A 66-year-old female patient suffered from recurrent reticulate erythema, purpura and gangrene on the distal portion of the extremities and face during the winter for 5 years. Cryofibrinogenemia was proven with the following evidences: (1) Histopathologic findings revealed many eosinophilic cylinders, about 6-9 microns in diameter, deposited within the lumen of the blood vessels in the dermis and subcutaneous tissue. There was no evidence of vasculitis. These cylinders were fibrinogen in nature, as proven by direct immunofluorescence. (2) Cryofibrinogen was detected in the citrated plasma, which was confirmed by double immunodiffusion, the presence of an IgG-kappa M protein was also revealed by immunofixation. Debridement and skin grafts were performed, and prednisolone combined with cyclophosphamide were given. Skin lesions improved without recurrence, and the "cryocrit" decreased from 13.6% to less than 2% during the follow up. We conclude that if there is any case with the similar cutaneous manifestations, cryofibrinogenemia should be considered.
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674
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675
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Hartman KR, Rawlings JS, Feingold M. Picture of the month. Protein C deficiency. AMERICAN JOURNAL OF DISEASES OF CHILDREN (1960) 1990; 144:1353-4. [PMID: 2244621 DOI: 10.1001/archpedi.1990.02150360079026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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