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LP-154 Peripheral gangrene in systemic lupus erythematosus – a rare case report
  1. Nurul Fadhilah1,
  2. Faridin Pango2,
  3. Femi Syahriani2,
  4. Endy Adnan2 and
  5. Abdul Rahman Umar2
  1. 1Internal medicine, Hasanuddin University, Indonesia
  2. 2Rheumatology Division of Internal Medicine, Hasanuddin University, Indonesia


Description Digital ulcers and gangrene are common cutaneous manifestations of connective tissue diseases. They are frequently seen in systemic sclerosis, but are relatively rare in systemic lupus erythematosus (SLE). There are only 0.2% SLE patients who initially present as digital gangrene.

We report a case of a 35-year-old woman presented with pain and necrosis of finger tips. She has been diagnosed with SLE for 2 years and was taking immunosuppressant regularly but quit the medication 6 month prior to admission and experience recurring Raynaud phenomenon. There is no history of infections, drug addiction, trauma, diabetes, miscarriage, or vascular disease. A diagnosis of SLE with digital gangrene has been established based on clinical appearance (figure 1). The patient has a High Disease activity with MEX SLEDAI score 14. Laboratory findings showed RNP/Sm +, RIB +, thrombocytopenic, anemia hemolytic, with high ESR 50/81 and no coagulopathy. On radiological examination, no signs of vascular disease nor thrombus were found. The patient was treated with steroid, methotrexate and sildenafil and showed clinical and laboratory improvement.

Conclusions We reported a case of A 35-year-old woman with a rare peripheral gangrene in Systematic Lupus Erythematosus. The patient shown clinical improvement after using corticosteroid, methotrexate, and sildenafil.

Abstract LP-154 Figure 1

Peripheral gangrene on both hands of a 35-years-old female with systemic lupus erythematosus

  • Systemic Lupus Erythematosus
  • Peripheral Gangrene
  • Raynaud Phenomenon

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