Diagnosis of Undifferentiated Connective Tissue Disease in a Patient With Digital Gangrene and Positive Antinuclear Antibodies

Abstract

The occurrence of ischemia of the digits or digital gangrene is a well-known complication of systemic autoimmune diseases, such as systemic sclerosis, systemic lupus erythematosus, and anti-phospholipid syndrome, among others. The pathophysiological mechanisms are small vessel vasculitis, vasospasm of Raynaud's phenomenon, microthrombi due to antiphospholipid syndrome, and/or accompanying accelerated atherosclerosis. Digital ischemia can also occur in the context of disseminated bacterial infections and sepsis. We present here the case of a patient who had digital ischemia and positive antinuclear antibodies but without well-defined clinical features of a connective tissue disease. A diagnosis of undifferentiated connective tissue disease was made.

Clinical characteristics and outcomes of digital gangrene in connective tissue disorders: a longitudinal single-centre experience from Jodhpur, India

“…We wish to highlight the importance of screening and thorough evaluation of young patients who present with digital gangrene require any underlying for CTD for early initiation of immune suppression which can prevent limb and organ threatening complications. We encountered 3 patients whose diagnosis remained elusive after extensive investigations and were hence classified as "Undifferentiated CTD"; similar findings were reported by Ravi et al in a case report [14].…”

Digital Gangrene and Antiphospholipid Syndrome in a Retinoblastoma Patient with Chromosome 13q Deletion: A Case Report

“…Digital gangrene most commonly occurs in children as a catheter-related complication [ 4 , 5 ]. The other causes are sepsis, vasculitis, hypercoagulability [6] , paraneoplastic syndrome [ 7 , 8 ], and chemotherapy [ 9 – 11 ]. To date, the only report on digital gangrene in a patient with retinoblastoma is the one by Das et al [7] .…”