title: 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).
authors.affiliation: Department of Rheumatology, Ankara University Medical Faculty, Sihhiye, 06410 Ankara, Turkey.
authors.forename: Orhan
authors.initials: O
authors.lastname: Küçükşahin
authors.affiliation: Department of Rheumatology, Ankara University Medical Faculty, Sihhiye, 06410 Ankara, Turkey.
authors.forename: Aşkın
authors.initials: A
authors.lastname: Ateş
authors.affiliation: Department of Internal Medicine, Ankara University Medical Faculty, Sihhiye, 06410 Ankara, Turkey.
authors.forename: Alexis K
authors.initials: AK
authors.lastname: Okoh
authors.affiliation: Department of Internal Medicine, Ankara University Medical Faculty, Sihhiye, 06410 Ankara, Turkey.
authors.forename: Emre
authors.identifier: 0000-0001-7883-2307
authors.initials: E
authors.lastname: Kulahcioglu
authors.affiliation: Department of Internal Medicine, Ankara University Medical Faculty, Sihhiye, 06410 Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Turgay
authors.affiliation: Department of Rheumatology, Ankara University Medical Faculty, Sihhiye, 06410 Ankara, Turkey.
authors.forename: Gülay
authors.initials: G
authors.lastname: Kınıklı
references.citation: Ann Rheum Dis. 2007 Aug;66(8):1122-3
references.pmid: 17626973
references.citation: Clin Exp Rheumatol. 2000 Nov-Dec;18(6):786
references.pmid: 11138352
references.citation: Arthritis Rheum. 2002 Apr;46(4):1019-27
references.pmid: 11953980
references.citation: Dakar Med. 2007;52(1):41-5
references.pmid: 19102091
references.citation: J Rheumatol. 1993 Sep;20(9):1598-600
references.pmid: 8164224
references.citation: J Dtsch Dermatol Ges. 2009 Oct;7(10):888-91
references.pmid: 19302565
references.citation: Rheumatol Int. 2009 Dec;30(2):277-9
references.pmid: 19701755
references.citation: Ann N Y Acad Sci. 2007 Jun;1108:497-504
references.pmid: 17894015
references.citation: J Dermatol. 1996 May;23(5):347-51
references.pmid: 8675827
references.citation: Autoimmunity. 1995;20(1):1-7
references.pmid: 7578856