Korean J Nephrol.  2010 Jul;29(4):501-503.

Acute Dermal Capillary Rupture in a Patient with Diabetic Nephropathy

• Yu HM
• Yun HE
• Baek YH
• Chon HK
• Park KT
• Ahn DS
• Kang KP
• Kim W
• Park SK
• Lee S

Abstract

A 46-year-old diabetic woman visited our hospital with generalized edema and high blood pressure. An appropriately sized noninvasive blood pressure cuff was placed on her right arm above the elbow to measure blood pressure. While we were checking her blood pressure, we noticed small red petechial spots distal to the cuff involving her entire right forearm. Her blood pressure was 170/96 mmHg. The laboratory findings showed no abnormality of anticoagulation. The rest of the patient's extremities were not affected. The petechiae on the right arm resolved spontaneously after ten days. The most likely explanation for these petechiae is acute dermal capillaryrupture, which is called the Rumpel- Leede phenomenon. Acute dermal capillary rupture appears as petechiae in an area following application of vascular constriction such as application of tourniquet to draw blood specimen or use of blood pressure cuff due to capillary fragility or abnormal platelets in numbers or in function. This situation has been reported previously in the literature as the Rumpel-Leede phenomenon in association with prolonged noninvasive BP monitoring. In the patient described herein, increased venous pressure from blood pressure measurement and capillary fragility associated with diabetes mellitus may have increased the risk of acute dermal capillary rupture.

Keyword

Capillary fragility; Diabetic nephropathy; Blood pressure

MeSH Terms

Arm
Blood Platelets
Blood Pressure
Capillaries
Capillary Fragility
Constriction
Diabetes Mellitus
Diabetic Nephropathies
Edema
Elbow
Extremities
Female
Forearm
Humans
Hypertension
Middle Aged
Purpura
Rupture
Tourniquets
Venous Pressure