Corticosteroid-Associated Blue Toe Syndrome: Role of Antiphospholipid Antibodies
Authors: Gregg E. Davies
Journal: Annals of Internal Medicine (1990)

Brief Reports1 December 1990Corticosteroid-Associated Blue Toe Syndrome: Role of Antiphospholipid AntibodiesGregg E. Davies, MD, Douglas A. Triplett, MDGregg E. Davies, MD, Douglas A. Triplett, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-113-11-893 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAntiphospholipid antibodies may be found in patients with various diseases, especially in those with systemic lupus erythematosus, or in patients without any apparent predisposing condition. The presence of antiphospholipid antibodies in patients with systemic lupus erythematosus is significantly associated with venous or arterial thromboembolism, neurologic disorders, and thrombocytopenia (1). In patients without systemic lupus erythematosus, an association between antiphospholipid antibodies and thromboembolic or other disorders has been strongly suspected but not conclusively proved (2, 3). We describe a patient with antiphospholipid antibodies and thrombocytopenia who twice developed the blue toe syndrome after receiving treatment with prednisone to increase the platelet...References1. Love P and Santoro S. Antiphospholipid antibodies: anticardiolipin and the lupus anticoagulant in systemic lupus erythematosus (SLE) and in non-SLE disorders. Ann Intern Med. 1990;112:682-98. LinkGoogle Scholar2. Asherson R, Khamashta M, and Ordi-Ros J. The "primary" antiphospholipid syndrome: major clinical and serological features. Medicine (Baltimore). 1989;68:366-74. CrossrefMedlineGoogle Scholar3. Triplett D and Brandt J. Lupus anticoagulants: misnomer, paradox, riddle, epiphenomenon. Hematol Pathol. 1988;2:121-43. MedlineGoogle Scholar4. Triplett D, Brandt J, Kaczor D, and Schaeffer J. Laboratory diagnosis of lupus inhibitors: a comparison of the tissue thromboplastin inhibition procedure with a new platelet neutralization procedure. Am J Clin Pathol. 1983;79:678-82. CrossrefMedlineGoogle Scholar5. Loizou S, McCrea J, Rudge A, Reynolds R, Boyle C, and Harris E. Measurement of anticardiolipin antibodies by an enzyme-linked immunosorbent assay (ELISA): standardization and quantitation of results. Clin Exp Immunol. 1985;62:738-45. MedlineGoogle Scholar6. Kaufman J, Karmody A, and Leather R. Atheroembolism and microthromboembolic syndromes (the blue toe syndrome and disseminated atheroembolism). In: Rutherford RB, ed. Vascular Surgery. 3d ed. Philadelphia: WB Saunders; 1989:565-72. Google Scholar7. Dodd H, Sarkany I, and O'Shaughnessy D. Widespread cutaneous necrosis associated with the lupus anticoagulant. Clin Exp Dermatol. 1985;10:581-6. CrossrefMedlineGoogle Scholar8. Alegre V, Gastineau D, and Winkelmann R. Skin lesions associated with circulating lupus anticoagulant. Br J Dermatol. 1989;120:419-29. CrossrefMedlineGoogle Scholar9. Grob J and Bonerandi J. Cutaneous manifestations associated with the presence of the lupus anticoagulant: a report of two cases and a review of the literature. J Am Acad Dermatol. 1986;15:211-9. CrossrefMedlineGoogle Scholar10. Alarcon-Segovia D and Sanchez-Guerrero J. Correction of thrombocytopenia with small dose aspirin in the primary antiphospholipid syndrome. J Rheumatol. 1989;16:1359-61. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Gregg E. Davies, MD; Douglas A. Triplett, MDFrom the University of Illinois College of Medicine, Urbana, Illinois; Veterans Affairs Medical Center, Danville, Illinois; and Ball Memorial Hospital, Muncie, Indiana. For current author addresses, see end of text. 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