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Anesth Analg 2007; 105:1561-1563
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000290304.02125.6e
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CARDIOVASCULAR ANESTHESIOLOGY

Periorbital Ecchymoses During General Anesthesia in a Patient with Primary Amyloidosis: A Harbinger for Bleeding?

Toby N. Weingarten, MD, Brian A. Hall, MD, Brian F. Richardson, MD, Roger E. Hofer, MD, and Juraj Sprung, MD, PhD

From the Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, Minnesota.

Address correspondence and reprint requests to Juraj Sprung, MD, PhD, Department of Anesthesiology, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN 55905. Address e-mail to Sprung.juraj{at}mayo.edu.

Abstract

Primary amyloidosis is a result of proliferation of a population of plasma cells that leads to an increased secretion of monoclonal immunoglobulins (amyloid). Amyloid protein infiltrates increase capillary fragility. Such capillaries can burst, even after minor stress, resulting in periorbital hemorrhage. We describe a 64-yr-old man with primary amyloidosis who underwent general anesthesia. His eyes were gently closed with tape. Upon removal of the tape bilateral periorbital purpura was noted. All coagulation studies were normal. The periorbital hemorrhage was attributed to amyloidosis-induced capillary fragility.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2007 by the International Anesthesia Research Society.