Treatment Resistant Severe Digital Ischemia Associated with Antiphospholipid Syndrome in a Male Patient with Systemic Sclerosis

Abstract

We report the case of a male patient with limited cutaneous systemic sclerosis (SSc) that was complicated with severe digital ischemia, resistant to medical treatment. Due to the lack of treatment response, further laboratory and imaging studies were conducted. Findings were compatible with antiphospholipid syndrome and oral warfarin was added to the treatment regimen. After successful anticoagulation no further recurrences of digital ischemia were seen. An underlying etiology in SSc patients with treatment resistant digital ischemic necrosis should be suspected for accompanying antiphospholipid syndrome (APS).

Antiphospholipid Syndrome - A Case Report of Pulmonary Thromboembolism, Followed with Acute Myocardial Infarction in Patient with Systemic Sclerosis

“…Clinical significance of our finding: The particular role of these antibodies in clinical manifestations of SSc is still unknown [ 7 ]. Searching threw the literature; we found a case report on association of APLs with cutaneous systemic sclerosis (SSc), with vascular complications that responded well to oral anticoagulant treatment (OAK) [ 9 ]. Also, a complicated case of vascular complication after CABG in patient with SLE, SSc and secondary APLs was referred by Naoto in 2011 [ 10 ].…”