Peripheral vascular occlusions leading to gangrene and amputations in antiphospholipid antibody positive patients

Ronald A. Asherson*, Ricard Cervera, Yehuda Shoenfeld

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingConference contributionpeer-review


Twenty-one cases from several medical centers (Brazil, Italy, Serbia, South Africa, Israel, and the United Kingdom) with severe peripheral vascular disease progressing to amputations of limbs/digits, all of whom tested positive for antiphospholipid antibodies, are documented. The patients were suffering from either systemic lupus erythematosus, discoid LE, "primary" antiphospholipid syndrome (PAPS), "lupus-like" disease, undifferentiated connective tissue disease. A high frequency of livedo reticularis preceding the arterial occlusions in our series of patients who subsequently progressed to ischemic necrosis and amputation of limbs/digits was noted. Five of the 10 patients, in whom histopathological studies had been performed, demonstrated the typical vasculopathy seen with the antiphospholipid syndrome ("APS vasculopathy"). Complicating vasculitis was present in seven of the patients. Five of the patients developed severe peripheral vascular disease during the course of the catastrophic antiphospholipid (Asherson's) syndrome.

Original languageEnglish
Title of host publicationAutoimmunity, Part D
Subtitle of host publicationAutoimmune Disease, Annus Mirabilis
PublisherBlackwell Publishing Inc.
Number of pages15
ISBN (Print)157331708X, 9781573317085
StatePublished - Jun 2007

Publication series

NameAnnals of the New York Academy of Sciences
ISSN (Print)0077-8923
ISSN (Electronic)1749-6632


  • Amputations
  • Antiphospholipid antibodies
  • Catastrophic antiphospholipid (Asherson's) syndrome
  • Livedo reticularis
  • Peripheral vascular diseases
  • Primary antiphosholipid syndrome
  • Systemic lupus erythematosus
  • Vasculitis


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