![]() ![]() There was also a variable decrease in elastic fibers and smooth muscle cells in the tunica media. There was an absence of internal elastic lamina and loss of muscle wall at the aneurysmal sites. Microscopic examination by a pathologist found that the radial artery was with variable smooth muscle thickness, partial loss of muscle wall, aneurysmal dilatation, fibrinoid necrosis and pseudoaneurysm surrounded by a moderately dense mixed inflammatory infiltrate and fibroblastic reaction. There was no numbness over bilateral upper limbs ( Figure 1). Left forearm compartments were not tense. Repeated physical examination found tense forearm compartments, and there was also limited right wrist and fingers movement the radial pulse was weakened. He was therefore treated as cellulitis initially with antibiotics.ĭuring patient’s stay, progressive right forearm swelling was noted. White blood cell count was 17.2 × 10 9/L and C-reactive Protein (CRP) was 190.1 mg/L. ![]() His bilateral wrists movement was normal. His bilateral forearms were mildly erythematous with bruising, mildly tender and with an increase in temperature. On admission, he had normal blood pressure and was afebrile. The patient did not complain of any paraesthesia of both upper limbs. There was no recent history of epileptic convulsion, insect bite or trauma. A 30-year-old Chinese man labelled as Ehlers–Danlos Syndrome (‘EDS’) due to positive family history, with the past history of epilepsy, admitted to our unit in the year 2017 with bilateral forearm redness and swelling for two days, with the right side being more severe. ![]()
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