title: Acute Limb-Threatening Ischemia Associated With Antiphospholipid Syndrome: A Report of Two Cases.
abstract: Acute limb ischemia results from sudden deterioration in the arterial supply to the limb, occasionally leading to limb loss or fatality. Antiphospholipid syndrome (APS) is known to induce acute limb ischemia among the various etiologies responsible for arterial obstruction. APS is a systemic autoimmune disorder characterized by a combination of arterial and/or venous thrombosis and limb loss. It is often accompanied by a mild-to-moderate thrombocytopenia and elevated titers of antiphospholipid antibodies, including the lupus anticoagulant and the anticardiolipin antibodies. In the present report, we present 2 cases of acute limb ischemia due to APS associated with systemic lupus erythematosus. Angiography revealed arterial obstruction distal to the popliteal artery in both patients, and each patient eventually underwent below-the-knee amputation. Surgeons treating acute limb ischemia should remember APS, although this disease might not be common in daily clinical practice.
authors.affiliation: Assistant Professor, Department of Plastic and Reconstructive Surgery, Saga University School of Medicine, Saga, Japan; Assistant Professor, Department of Plastic and Reconstructive Surgery, Saitama Medical University, Saitama, Japan. Electronic address: suzukiwako@yahoo.co.jp.
authors.forename: Kiwako
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Professor, Department of Plastic and Reconstructive Surgery, Saga University School of Medicine, Saga, Japan.
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Uemura
authors.affiliation: Lecturer, Department of Plastic and Reconstructive Surgery, Saga University School of Medicine, Saga, Japan.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Kikuchi
authors.affiliation: Assistant Professor, Department of Plastic and Reconstructive Surgery, Saga University School of Medicine, Saga, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ishihara
authors.affiliation: Professor, Department of Plastic and Reconstructive Surgery, Saitama Medical University, Saitama, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Ichioka
mesh_terms: D000368:Aged; D016736:Antiphospholipid Syndrome / Q000150:complications*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000209:etiology* / Q000473:pathology* / Q000628:therapy; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged
keywords: acute arterial occlusion; antiphospholipid syndrome; major amputation; systemic lupus erythematosus