According to the authors of the new report, an 84-year-old man reported to his primary care doctor in Japan with discoloration and pain in his fingers and toes that had gotten worse over a two-week period. He’d also developed a 100-degree fever and general feelings of malaise, as well.
His doctors described “blue-black discoloration” on his left hand, “dusky discoloration” on his right hand, bruising and lesions on both hands, and more of the same on the toes of both feet. Lab tests revealed normal kidney and liver function, but they did show that he had an elevated C-reactive protein level—an indication of inflammation throughout the body.
It was clear that this man was suffering from necrosis, or tissue death, in his fingers and toes. But there are many possible causes of this, his doctors wrote, including infection, arterial embolism, and blood clotting disorders. The patient was tested for these and other conditions, all of which came back negative.
The doctors assumed that the patient was suffering from vasculitis, a condition in which a person’s immune system attacks his or her blood vessels, causing inflammation that gradually thickens and weakens artery walls. This can result in blood restriction to extremities, hence the scary-looking—and literally dying—hands and feet. The patient started on a steroid treatment to reduce that inflammation, and doctors performed biopsies on his lesions that confirmed their suspicions.
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