A Case of Successful Treatments of Venous Leg Ulcers in Secondary Antiphospholipid Syndrome

Beom Kyung Kim; Sang Tae Choi; Myoung Kyun Son; Kwang Hoon Lee; Sang Won Lee; Sae Jin Chung; Ji Hoon Gil; Yong Beom Park; Soo Kon Lee

doi:10.4078/jkra.2007.14.1.71

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Kim, Choi, Son, Lee, Lee, Chung, Gil, Park, and Lee: A Case of Successful Treatments of Venous Leg Ulcers in Secondary Antiphospholipid Syndrome

Original Article

J Korean Rheum Assoc 2007;14(1):71-77.

Published online: 23 March 2007

DOI: https://doi.org/10.4078/jkra.2007.14.1.71

A Case of Successful Treatments of Venous Leg Ulcers in Secondary Antiphospholipid Syndrome

Beom Kyung Kim, M.D.^∗, Sang Tae Choi, M.D.^∗, Myoung Kyun Son, M.D.^∗, Kwang Hoon Lee, M.D.^∗, Sang Won Lee, M.D.^∗, Sae Jin Chung, M.D.^∗, Ji Hoon Gil, M.D.^∗, Yong Beom Park, ∗M.D.^∗,^∗∗,^∗∗∗, Soo Kon Lee, M.D.^∗,^∗∗,^∗∗∗

^∗Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea

^∗∗Institute for Immunology and Immunological Disease, Yonsei University College of Medicine, Seoul, Korea

^∗∗∗BK21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea

Received 1 September 200620 November 2006

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Antiphospholipid syndrome is an autoimmune disorder characterized by recurrent arterial or venous thrombosis, and pregnancy loss. A 57-year-old woman was admitted for aggravation of both leg ulcers. Venogram showed chronic venous obstructions at both lower extremities, and chest x-ray and computed tomography revealed serositis in pericardium and pleura. The laboratory tests revealed pancytopenia, and positive tests for antinuclear antibody, anti-dsDNA antibody, lupus anticoagulant and anticardiolipin antibody, which led to a diagnosis of anti- phospholipid syndrome secondary to systemic lupus erythematous. After medical treatments by anticoagulation and immunosuppression, and surgical managements including subtotal skin graft and local flap surgery, leg ulcers had been successfully treated without recurrence. Recognition of antiphospholipid syndrome as a cause of venous ulcer and the treatment plans including anticoagulation and surgical management is important in proper managements.

Keywords: Antiphospholipid syndrome, Venous thrombosis, Leg ulcer, Systemic lupus erythematous

REFERENCES

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Fig. 1.

There was 3 X4 cm sized ulcer at right lower tibia (A), and 2 X3 cm sized ulcer at left malleus area (B).

Fig. 2.

Distal obstructions of left posterior tibial artery, and right anterior · posterior tibial artery were found in the arteriogram.

Fig. 3.

Venograms showed chronic obstruction from right infrapopliteal veins to right common femoral vein with superficial collateral vein (A), and multiple obstructions at left tibioperoneal vein (B).

Fig. 4.

Right ulcer was covered with subtotal skin graft (A), and left ulcer with local adiofascial flap and subtotal skin graft (B).

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