A bleeding disorder caused by a cardiac tumor:case report

A 22-year-old female developed symptomatic thrombocytopenia. On physical examination, apart from ecchymoses. a loud holosystolic murmur was heard. Echocardiography revealed a cardiac rumor. The thrombocytopenia did not respond to corticosteroids, but after surgical removal of the intracardiac tumor, a papillary fibroelastoma, the platelet count normalised. There are no similar case reports in the literature. Our case report illustrates that thrombocytopenia may he associated with a cardiac tumor and that complete physical examination is essential in every patient presenting with easy bruising. (C) 2001 Elsevier Science B.V. All rights reserved

TRANSCUTANEOUS ELECTRICAL NERVE-STIMULATION (TENS) IN RAYNAUDS-PHENOMENON

Transcutaneous nerve stimulation (TENS) has been described as resulting in vasodilatation. The effect of 2 Hz TENS of the right hand during forty-five minutes on skin temperature and plethysmography of the third digit of both hands and feet and on transcutaneous oxygen tension (TcpO2) of the right hand was compared with that of a control study using indifferent stimulation of the iliopsoas region in 8 patients with primary Raynaud's phenomenon. After TENS a slight increase in skin temperature of both hands was found, while plethysmographic amplitude was increased in the contralateral hand only. No changes in TcpO2 occurred. The authors conclude that the observed small effects of TENS are of no clinical value in primary Raynaud's phenomenon