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Case Reports
. 2021 Oct:76:289-292.
doi: 10.1016/j.avsg.2021.05.012. Epub 2021 Jun 25.

Treatment-Resistant Acute Upper Limb Ischemia in a Patient With Systemic Lupus Erythematous and Concomitant SARS-CoV-2 Infection: A Case Report

Martina Nespola  1 , Pasqualino Sirignano  2 , Nicoletta Fermani  1 , Cesare Battocchio  1 , Filomena Tosti  1 , Chiara Pranteda  1 , Maurizio Taurino  1
Affiliations
Case Reports

Treatment-Resistant Acute Upper Limb Ischemia in a Patient With Systemic Lupus Erythematous and Concomitant SARS-CoV-2 Infection: A Case Report

Martina Nespola et al. Ann Vasc Surg. 2021 Oct.

Abstract

To describe the case of a young female patient, affected by Systemic Lupus Erythematous, hospitalized for severe SARS-CoV-2 infection pneumonia and presenting a treatment-resistant acute upper limb ischemia. Two days after hospital admission, the patient suffered sudden right upper limb pain associated with mild functional impairment. At physical examination, radial and ulnar pulses were absent, and no flow signal was detected at duplex ultrasound scan. Therefore, an acute limb ischemia diagnoses was posed. Despite several surgical and endovascular revascularization attempts, the patient underwent an above the elbow amputation in 10th postoperative day from first surgical embolectomy, and she died for respiratory failure 25 days after hospitalization. Our case of acute upper limb ischemia seems to confirm that clinical manifestation and fate of thrombotic disorder in COVID-19 patients could be precipitated by concomitant autoimmune diseases.

Keywords: COVID 19; SARS-CoV-2; acute limb ischemia; arterial thrombosis.

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Figures

Fig 1
Fig. 1
Digital subtraction angiography showing contrast medium extravasation from brachial artery patch.
See this image and copyright information in PMC

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