40y old male pt, symptoms of viral fever, such eruptions on 3rd day, paracetamol and cough syrup was prescribed, could it be drug related? what investigations are required?

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Porphyrias Porphyrias are a group of rare inherited blood disorders. People with these disorders do not make heme, a component of hemoglobin (protein in red blood cells that carries oxygen) properly. Heme is made of porphyrin (a naturally-occurring organic compound in the body) bound to iron. Heme helps red blood cells (RBCs) carry oxygen and also gives RBCs their color. It is also found in myoglobin, a protein in the heart and skeletal muscles. The body goes through several steps to make heme. However, in people with porphyria, the body lacks certain enzymes needed to complete this process, causing porphyrin to accumulate in tissues and blood. This may cause a variety of symptoms, ranging from mild to severe. The most common symptoms of porphyria are abdominal pain, light sensitivity (causing rashes or blisters), and problems with the muscles and nervous system. The symptoms of porphyria vary and depend on which enzyme is missing. Causes Porphyria is a genetic disease. According to The Journal of Family Planning (JFP), most types of porphyria are autosomal dominant, meaning that a person only inherits the abnormal gene from one parent. (JFP, 2012) However, certain factors may trigger symptoms, known as attacks. Factors include: drugsinfectionalcohol usecertain hormones, such as estrogensunlight Symptoms Symptoms depend upon the type of porphyria. Severe abdominal pain is present in all types, as well as urine that is reddish-brown in color. This is caused by the build-up of porphyrins, and typically occurs after an attack. Symptoms associated with hepatic disease include: limb painneuropathyhypertensiontachycardia (fast heartbeat)electrolyte imbalance Symptoms associated with erythropoietic disease include: extreme skin sensitivity to lightanemia (when the body does not produce enough new RBCs)changes in skin pigmentationerratic behavior related to sun exposure Treatment There is no cure for porphyria. Treatment focuses on managing symptoms. Most cases are treated with medication. Treatments for hepatic disease include: beta blockers (Atenolol) to manage blood pressurehigh carbohydrate diet to aid recoveryopioids for pain managementhematin to shorten attacks Treatments for erythropoietic disease include: iron supplements for anemiablood transfusionsbone marrow transplant
Nice explan Dr farooq
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Petechial rash on 3rd day of illness..could b due to 1.viral exanthem..2. Evn analgesics are known to cause drug purpura..3.ITP usualy develops within weeks durig recovery from viral illness..so its also a remote posibility 4. Acute HIV syndrome can present wid al dese symptoms provided LNpathy n wt loss z present..5. Rare manifestation of acute leukemias or MDS bt in elderly.. I guess a completete blood count with good pbs review wil help clinching the diagnosis..if eosinophil counts r increased dn DRESS to b considered
This is petechial rash if they are blanching... Platelet Transfusion if thrombocytopenia...ask for duration of rash..if duration is long ,it could be a case of ITP precipitated by viral fever
? VIRAL FEVER.. ? DENGUE FEVER.. ? ITP.. NEED'S CLINICOPATHOLOGICAL EVALUATION WITH.. * BLOOD CBC CT BT PT.. * BSR..HBA1C.. *LFT..KFT.. * MP WIDAL DENGUE.. * URINE ROUTINE
it is not drug allegy they produce fixed eruptions not only on limbs but on trunk also .it looks like typical rash of viral exanthem
Dear Dr, do a complete blood count, platelet count, bleeding time, clotting time.
Suspecting ITP
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CBS MP Widal What's a actual count of Platelets...?
May be dengue..
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Thanks for your notes ( can be found in any standard books on Hematology) but you are 100% sure that it is a case of Purpura?
SUGGESTIVE OF PATECHIAL RASHES VIRAL. EXANTHEM DENGUE DD . I. T. P... NEEDS. INVESTIGATIONS
Go for covid test as such findings r seen in some pts of Corona. So better to rule out early.
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