Large vessel occlusion and gangrene in systemic lupus erythematosus and 'lupus-like' disease. A report of six cases

Six patients are presented, all of whom had systemic lupus erythematosus or a 'lupus-like' disease and who developed major thromboses with gangrene of the extremities. Four of the 6 patients had circulating antiphospholipid antibodies at some point during the course of their illness. These serological markers, which have been associated with a tendency to thrombosis, may have contributed to the development of gangrene in these patients. Histological examination of affected arteries in 4 patients did not show any evidence of vasculitis. One patient in whom antiphospholipid antibodies were negative showed healing vasculitis on histology.