Phlegmatia Cærulea Dolens Complicated By Rhabdomyolysis

Abstract

68-year-old patient, with a history of arterial hypertension, admitted to the emergency department for pain in the left lower limb lasting for 8 hours. On physical examination, the limb was cold cyanotic, with edema extending from the foot to the thigh (figure 1). The popliteal pulse was very weak and the Homans sign was positive. Laboratory tests showed D Dimer at 1200 μg/L, creatinine at 210 μmol/l and creatine phosphokinase at 360 IU/l. Dopller ultrasound revealed a thrombosis of the common femoral vein extended to the external iliac vein. The arteries of the lower limbs were patent. The diagnosis of phlegmatia caerulea dolens complicated by rhabdomyolysis was made. The treatment was medical, combining rehydration with a saline infusion and heparin therapy (unfractionated heparin). The evolution was favorable, with normalization of renal function and disappearance of pain. The patient left the hospital after 15 days with treatment based on apixiban.