title: Critical peripheral ischemia precipitated by severe episode of Raynaud's phenomenon in a patient with aPL-positive systemic lupus erythematosus, upon high titer anti-RNP seroconversion.
abstract: A 35-year-old female with long standing aPL-positive lupus without history of thromboembolic events, who has developed critical peripheral ischemia (CPI) is described. An episode of severe Raynaud's phenomenon rapidly progressed to an extensive digit-threatening ischemia, involving bilateral hands and feet. She was successfully treated with corticosteroids, anticoagulation, iloprost, sildenafil, and nifedipine. Her serological studies were remarkable for the emergence of high titer anti-RNP seroconversion and an increase in aPL titer, suggesting that these autoantibodies played a role in the pathogenesis of CPI. It is important to note that such observation should herald this potentially devastating complication of systemic lupus erythematosus.
authors.affiliation: Assaf Harofeh Medical Center, Internal Medicine B, Rheumatology Unit; Tel Aviv University, Sackler School of Medicine oferl@asaf.health.gov.il.
authors.forename: O
authors.initials: O
authors.lastname: Levy
authors.affiliation: Assaf Harofeh Medical Center, Internal Medicine B, Rheumatology Unit; Tel Aviv University, Sackler School of Medicine.
authors.forename: I
authors.initials: I
authors.lastname: Maslakov
authors.affiliation: Assaf Harofeh Medical Center, Internal Medicine B, Rheumatology Unit; Tel Aviv University, Sackler School of Medicine.
authors.forename: S
authors.initials: S
authors.lastname: Vosco
authors.affiliation: Assaf Harofeh Medical Center, Internal Medicine B, Rheumatology Unit; Tel Aviv University, Sackler School of Medicine.
authors.forename: A
authors.initials: A
authors.lastname: Markov
authors.affiliation: Assaf Harofeh Medical Center, Internal Medicine B, Rheumatology Unit; Tel Aviv University, Sackler School of Medicine.
authors.forename: M
authors.initials: M
authors.lastname: Amit-Vazina
authors.affiliation: Assaf Harofeh Medical Center, Internal Medicine B, Rheumatology Unit; Tel Aviv University, Sackler School of Medicine.
authors.forename: M
authors.initials: M
authors.lastname: Tishler
mesh_terms: D000328:Adult; D005121:Extremities / Q000098:blood supply*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000276:immunology*; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000276:immunology; D011928:Raynaud Disease / Q000150:complications* / Q000276:immunology
keywords: Anti-RNP antibodies; Raynaud's phenomenon; anticardiolipin antibodies; critical peripheral ischemia