Lower extremity arterial disease in systemic lupus erythematosus
M. J. Wheatley, H. A. Hennein and L. J. Greenfield
Department of Surgery, University of Michigan Medical School, Ann Arbor.
Lupus vasculitis primarily affects microvascular circulation, and
large-vessel thrombosis is a rare complication of this disease.
Large-vessel occlusive disease in systemic lupus erythematosus 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.
