Vasculitis in patients with systemic sclerosis and severe digital ischaemia requiring amputation

Objectives - To document the incidence of histological vasculitis in amputation specimens from patients with severe digital ischaemia secondary to systemic sclerosis (SSc), and to look for an association between anticardiolipin (aCL) antibodies and severe digital ischaemia in SSc. Methods - This was a retrospective review of patients with SSc who underwent amputation for digital ischaemia over a three year period. Results - Five of nine patients had histological vasculitis, four of who had aCL antibodies, although these were not present in high titre. Conclusion - Vasculitis does occur in SSc, at least in that subgroup with severe peripheral ischaemia. These findings could have implications for treatment of this subgroup of patients with SSc.