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Lower Extremity Arterial Disease in Systemic Lupus Erythematosus FREE

Micheal J. Wheatley, MD; Hani A. Hennein, MD; Lazar J. Greenfield, MD
[+] Author Affiliations

Accepted for publication July 22, 1990.

Reprint requests to Department of Surgery, University of Michigan Medical Center, 1500 E Medical Center Dr, Ann Arbor, MI 48109 (Dr Greenfield).


Arch Surg. 1991;126(1):109-110. doi:10.1001/archsurg.1991.01410250117021
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• Lupus vasculitis primarily affects microvascular circulation, and large-vessel thrombosis is a rare complication of this disease. Large-vessel occlusive disease in systemic lupus erythe-matosus is most likely related to hypercoagulability in addition to immune complex–mediated endothelial damage. We describe the 11th and 12th patients reported to have systemic lupus erythematosus and macrovascular occlusive disease of the lower extremities. Our experience and a review of the literature suggest that, while aortoiliac disease is amenable to bypass or endarterectomy, infrainguinal disease is rarely correctable surgically, and amputation becomes necessary in most of these patients.

(Arch Surg. 1991;126:109-110)

REFERENCES

Bakker FC, Rauwerda JA, Bernelot Moens HJ, van den Broek TAA.  Intermittent claudication and limb-threatening ischemia in systemic lupus erythematosus and SLE-like disease: a report of two cases and review of the literature . Surgery . 1989;;106:21-25.
Keat ECB, Shore JH.  Gangrene of the legs in disseminated lupus erythematosus . BMJ . 1958;;1:25-27.
Galdstein GS, Rynes RI, Parhami N, Bartholomew LE.  Gangrene of a foot secondary to systemic lupus erythematosus with large vessel vasculitis . J Rheumatol . 1979;;6:549-553.
Lamotte M, Martin E, Labrousse C, Choussat A.  Accidents ischemiques aigus aortique et mesenterique au cours d'un lupus erythemateux dissemine . Semin Hop Paris . 1966;;42:2424-2429.
Cornet A, Dubrisay J, Godeau P, et al.  Maladie thrombosante au cours d'un syndrome lupique revele par un oestroprogestatif . Ann Med Interne (Paris) . 1971;;122:1151-1154.
DePalma RG, Moskowitz RW, Hosden WD.  Peripheral ischaemia and collagen disease. Clinical manifestations, diagnosis and treatment . Arch Surg . 1972;;105:313-318.
Kaufman JL, Bancilla E, Slade J.  Lupus vasculitis with tibial artery thrombosis and gangrene . Arthritis Rheum . 1986;;29:1291-1292.
Asherson RA, Derdsen RHWM, Harris EN, et al.  Large vessel occlusion and gangrene in systemic lupus erythematosus and 'lupus-like' disease: a report of six cases . J Rheumatol . 1986;;13:740-747.
Glueck HI, Kant KS, Weiss MA, Pollack VE, Miller MA, Coots M.  Thrombosis in systemic lupus erythematosus: relations to the presence of circulating anticoagulants . Arch Intern Med . 1985;;145:1389-1395.
Boey ML, Coalaco CB, Gharavi AE, Elkon KB, Loizou S, HughesGHV.  Thrombosis in systemic lupus erythematosus: striking association with the presence of circulating lupus anticoagulant . BMJ . 1983;;287:1021-1023.
Harris EN, Gharavi AE, Hughes GRV.  Anti-phospholipid antibodies . Clin Rheum Dis . 1985;;11:591-609.

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Bakker FC, Rauwerda JA, Bernelot Moens HJ, van den Broek TAA.  Intermittent claudication and limb-threatening ischemia in systemic lupus erythematosus and SLE-like disease: a report of two cases and review of the literature . Surgery . 1989;;106:21-25.
Keat ECB, Shore JH.  Gangrene of the legs in disseminated lupus erythematosus . BMJ . 1958;;1:25-27.
Galdstein GS, Rynes RI, Parhami N, Bartholomew LE.  Gangrene of a foot secondary to systemic lupus erythematosus with large vessel vasculitis . J Rheumatol . 1979;;6:549-553.
Lamotte M, Martin E, Labrousse C, Choussat A.  Accidents ischemiques aigus aortique et mesenterique au cours d'un lupus erythemateux dissemine . Semin Hop Paris . 1966;;42:2424-2429.
Cornet A, Dubrisay J, Godeau P, et al.  Maladie thrombosante au cours d'un syndrome lupique revele par un oestroprogestatif . Ann Med Interne (Paris) . 1971;;122:1151-1154.
DePalma RG, Moskowitz RW, Hosden WD.  Peripheral ischaemia and collagen disease. Clinical manifestations, diagnosis and treatment . Arch Surg . 1972;;105:313-318.
Kaufman JL, Bancilla E, Slade J.  Lupus vasculitis with tibial artery thrombosis and gangrene . Arthritis Rheum . 1986;;29:1291-1292.
Asherson RA, Derdsen RHWM, Harris EN, et al.  Large vessel occlusion and gangrene in systemic lupus erythematosus and 'lupus-like' disease: a report of six cases . J Rheumatol . 1986;;13:740-747.
Glueck HI, Kant KS, Weiss MA, Pollack VE, Miller MA, Coots M.  Thrombosis in systemic lupus erythematosus: relations to the presence of circulating anticoagulants . Arch Intern Med . 1985;;145:1389-1395.
Boey ML, Coalaco CB, Gharavi AE, Elkon KB, Loizou S, HughesGHV.  Thrombosis in systemic lupus erythematosus: striking association with the presence of circulating lupus anticoagulant . BMJ . 1983;;287:1021-1023.
Harris EN, Gharavi AE, Hughes GRV.  Anti-phospholipid antibodies . Clin Rheum Dis . 1985;;11:591-609.

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