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Paraneoplastic acral vascular syndrome: case presentation and literature review
  1. Sara AlRasbi1,2,
  2. Amira H Al-Badi2 and
  3. Abdullah M Al Alawi1,2
  1. 1Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman
  2. 2Oman Medical Specialty Board, Internal Medicine, Muscat, Oman
  1. Correspondence to Dr Amira H Al-Badi; amira.hamed.93{at}


A 65-year-old man, a smoker, presented to the emergency department with progressive digital ischaemia, fever and weight loss. The clinical examination revealed generalised lymphadenopathy and ischaemic changes of the right distal phalanges of the second, third and fourth fingers. He had an ultrasound-guided biopsy of the cervical lymph node, which showed histopathological findings of classic Hodgkin’s lymphoma. Paraneoplastic acral vascular syndrome (PAVS) is a rare phenomenon and seen more in solid malignancies. There are very few reported cases of PAVS in haematological malignancies, including Hodgkin’s lymphoma. This case highlights the idea that the presence of acral vascular syndrome—especially in older patients—should alert physicians to search for an underlying malignancy as part of the medical evaluation. Also, it shows that medical treatment may slow the progress of the digital ischaemia until the culprit tumour has been identified and treated.

  • haematology (incl blood transfusion)
  • vasculitis

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  • Contributors SA is the first author, she involved on writing up the manuscript and taking care of this patient during his admission. AHKA-B: worked on writing up and reviewing the manuscript. AMAA: worked on writing up and reviewing the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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