title: Cutaneous necrosis associated with the lupus anticoagulant.
abstract: Extensive cutaneous necrosis of the limbs with sudden onset was observed in 3 women suffering from benign systemic lupus erythematosus. All 3 had a circulating anticoagulant and a positive venereal diseases reference laboratory test without anticardiolipin antibodies. They were successfully treated with pulse methylprednisolone therapy and plasmapheresis. The necrosis-lupus anticoagulant relationship is discussed due to the absence of another possible etiology for cutaneous necrosis and the latter's histological aspect, i.e., thromboses of the dermal and hypodermal vessels without vasculitis. This cutaneous necrosis resembles that observed in congenital protein C deficiencies and favors the hypothesis of interaction between the lupus anticoagulant and the protein C-S complex.
authors.affiliation: Service de Médecine Interne, Groupe Hospitalier Pitié-Salpétrière, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Francès
authors.forename: B
authors.initials: B
authors.lastname: Tribout
authors.forename: S
authors.initials: S
authors.lastname: Boisnic
authors.forename: L
authors.initials: L
authors.lastname: Drouet
authors.forename: A M
authors.initials: AM
authors.lastname: Piette
authors.forename: J C
authors.initials: JC
authors.lastname: Piette
authors.forename: O
authors.initials: O
authors.lastname: Blétry
authors.forename: B
authors.initials: B
authors.lastname: Wechsler
authors.forename: P
authors.initials: P
authors.lastname: Godeau
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000276:immunology*; D001779:Blood Coagulation Factors / Q000276:immunology*; D005260:Female; D006801:Humans; D007866:Leg; D016682:Lupus Coagulation Inhibitor; D008180:Lupus Erythematosus, Systemic / Q000276:immunology* / Q000628:therapy; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D009336:Necrosis; D010956:Plasmapheresis; D012867:Skin / Q000473:pathology*
chemical_list: D001323:Autoantibodies; D001779:Blood Coagulation Factors; D016682:Lupus Coagulation Inhibitor; D008775:Methylprednisolone