A Case of Leriche Syndrome

Case Report Patient: 36-year-old male Chief complaint: Pain and intermittent claudication of both lower extremities for 5 years Physical examination: At admission, blood pressure of 120/100 mmHg, body temperature of 36.8C, pulse of 68/min and respiratory rate of 19/min were checked. His femoral pulses were absent in both lower extremities accompanying pallor and coldness. The ankle-brachial index (ABI) was reduced (Rt. 0.77 and Lt. 0.49). Past medical history: He had hypertension, but not dyslipidemia or diabetes mellitus. Laboratory tests: Laboratory test revealed white blood cell (WBC) of 10.09×10/mL, Hb of 14.8 g/dL and platelet of 25×10/mL. Erythrocyte sedimentation rate (ESR), CRP, blood chemistries and autoantibodies and tests for viral infections were within normal limit or all negative. Radiologic findings: Computed tomography (CT) angiography showed complete occlusion of infrarenal aorta and left common iliac artery with collaterals into right common iliac and left external iliac artery (Fig. 1). Diagnosis and treatment: A diagnosis of Leriche syndrome was made with characteristic clinical symptoms, including ischemic pain and intermittent claudication of both lower extremities and radiographic findings. He denied to operative treatment of aorto-iliac and aorto-femoral graft bypass surgery. Thus he has been treating with antihypertensive and anti-platelet drugs.