Presenting complaints: A 69-year-old woman presented with a generalized petechial rash and dyspnea for the past three days. Fever, headache, dizziness, hemoptysis, or bleeding was absent. Patient medical history The patient was a known case of hypertension and was on enalapril for several years. There was no history of any new drug prescription, food intake, or contact with any sick patient. Physical examination: The rash was nonpruritic, painless, and developed initially on the thigh, progressing later to the entire body. The rash was nonpalpable and more prominent in the lower extremities.
Progressive dyspnea on exertion, with a decrease in exercise tolerance. The patient was afebrile and normotensive, with a respiratory rate of 22 bpm on admission. Cardiovascular, abdominal, and neurological examinations were normal. Palpable lymphadenopathy or visceromegaly was absent. Laboratory…
