The distinction between vasculitis coincidental with and one that is causally related to the antiphospholipid syndrome

Dermatologic aspects of antiphospholipid syndrome

“…confusion between perivascular inflammatory cell infiltrate and true vasculitis; in addition, the incorrect acceptance of immune complex deposition as evidence of vasculitis and, in particular, the lack of distinction between vasculitis coincidental with APS and vasculitis that is causally related to APS have helped to fuel the controversy. 74,75 It must be emphasized that the distinction between the thrombotic or vascular nature of vascular lesions in APS is important in order to select the appropriate treatment. A large number of the reported cases of vascular occlusive disease in APS are thrombotic in nature, although some may mimic vasculitis.…”

Vasculitis in Antiphospholipid Syndrome

“…When histopathologic vasculitis is found in APS, it is usually a contemporaneous phenomenon and is not causally related to the APS. 8 Concurrent vasculitis and APS most commonly occur in a patient with SLE or another underlying connective tissue disease. 9 Vasculitis occurs in approximately 10% to 35% of SLE patients, with small-vessel cutaneous vasculitis accounting for 80% of cases; aPL antibodies are found in 40% of SLE patients.…”

Well‐imaged large vessel vasculitis attributed to anticardiolipin antibody

“…A pathogenetic role for anticardiolipin antibodies in endothelial activation and thrombosis seems certain, but the putative mechanisms remain speculative (1-5). Dispute remains about whether true vasculitis with neutrophilic infiltrations of media in larger vessels can be attributed to anticardiolipin antibody (6,7). We report the case of a 50-year-old man with widespread vascular disease of the extremities which we believe to be vasculitis, based on the results of extensive serial imaging, monitoring of the acutephase response, and the clinical failure of anticoagulation therapy with subsequent success of therapy with intravenous pulse methylprednisolone and cyclophosphamide .…”