PMID: 6407406Jun 1, 1983Paper

Gangrene developing after minor surgery in a patient with undiagnosed systemic lupus erythematosus and lupus anticoagulant

Annals of the Rheumatic Diseases
B K JindalA Gayner

Abstract

We report a case of progressive peripheral ischaemia and gangrene as a presenting feature of systemic lupus erythematosus. It developed in a previously asymptomatic 40-year-old woman following minor surgery to her toe. Eventually she required a below-knee amputation and despite systemic corticosteroids continued to deteriorate, presenting later with signs of systemic intravascular thromboses. Histopathology and immunofluorescence on vessels repeatedly failed to demonstrate any evidence for vasculitis. A full coagulation screen confirmed the presence of 'lupus' anticoagulant. A plasma exchange was performed to remove circulating immunoglobins and she made a rapid and sustained recovery. Peripheral gangrene has not previously been described in association with lupus anticoagulant. We would suggest that in all cases of systemic thrombosis or unexplained peripheral vascular ischaemia lupus anticoagulant should be considered.

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Citations

May 20, 2005·Clinical Rheumatology·Maria Cristina Baquero Teixeira da RochaMittermayer Barreto Santiago
Apr 1, 1995·Cardiovascular Pathology : the Official Journal of the Society for Cardiovascular Pathology·S E Ford, P M Ford
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Oct 1, 1993·Annals of the Rheumatic Diseases·J P Drenth, A M Prieur
Sep 26, 2007·Annals of the New York Academy of Sciences·Ronald A AshersonYehuda Shoenfeld
Oct 1, 1990·Seminars in Arthritis and Rheumatism·L R SammaritanoM D Lockshin

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