, porcelain-white scars and cerebral thromboses.
Patients who developed livedo reticularis were significantly more likely than those without such lesions to have seizures, Raynaud's phenomenon, arterial events (cerebral or ocular ischemic events in particular), systemic hypertension (higher than 160/90 mm Hg), and heart valve abnormalities as revealed on echocardiography.
On the other hand, livedo reticularis patients were significantly less likely to have venous thrombosis alone than patients without the skin condition.
was noted, and methylprednisolone (125 mg q8h i.
Table 1 Criteria for Diagnosis of Antiphospholipid Syndrome (1) * Clinical Thrombosis: 1 confirmed episode(s): venous, arterial, or small vessel Exclusion of other causes, male 55 y, female 65 y Pregnancy: 1 unexplained deaths >10 wk 1 pre-eclampsia/placental insufficiency <34 wk 3 unexplained consecutive spontaneous abortions <10 wk Exclusion of other causes aPL-associated (individual diagnosis) Cardiac valve disease Livedo reticularis
Thrombocytopenia Nephropathy Laboratory Medium/high IgG or IgM aCL, anti-[[beta].
In contrast, physicians caring for aPL-positive patients recognize other associated complications that include livedo reticularis, valvular heart disease, or thrombocytopenia, at times in the absence of more typical vascular or pregnancy events (Table 2).
Livedo reticularis in young patients with a history of vascular or pregnancy events should raise the possibility of aPL, although livedo is not specific for APS and may be a normal variant.
The spectrum of manifestations associated with APS is broad and includes, in addition to thrombosis and pregnancy morbidity, thrombocytopenia, livedo reticularis, cardiac valvular disease, and an acute syndrome of multiorgan thrombosis termed "catastrophic antiphospholipid syndrome.
Every few months at his hospital, however, clinicians see a woman with a history of fetal loss or venous thrombosis--other diagnostic clues to the disorder--and will note the presence of livedo reticularis in the chart without recognizing the very strong association of the rash with antiphospholipid syndrome, said Dr.
In otherwise healthy women, livedo reticularis may be benign, but in women with other symptoms of antiphospholipid syndrome, it's a sign of a larger problem, said Dr.
Key Words: anticardiolipin antibodies, Graves disease, hyperthyroidism, livedo reticularis, thyroid
The case of a patient who developed livedo reticularis during uncontrolled Graves hyperthyroidism is described.