Primary Antiphospholipid Syndrome Causing Critical Limb Ischemia and Ultimately Amputation in an Otherwise Healthy Young Female.

Abstract

This case report describes an otherwise healthy 43-year-old female who presented with severe pain, foot drop, and critical limb ischemia to her left foot caused by thrombosis of a peripheral artery secondary to antiphospholipid syndrome. Antiphospholipid syndrome is an autoimmune disease that frequently manifests as recurrent arterial and/or venous thrombotic events, ischemic strokes, and miscarriages. Antiphospholipid syndrome affecting primarily the arteries is less common as compared to venous thrombosis. Our patient underwent several vascular surgical interventions and anticoagulant treatment; despite this, she ultimately underwent a below-the-knee amputation due to worsening ischemia. The purpose of the current case report is to emphasize that antiphospholipid syndrome should be kept on the differential for arterial ischemic events such as critical limb ischemia without another known cause and should be managed with an interprofessional team approach.