Neupane Bidhan, Islam Md Nazrul, Ahmedullah Abul Khair, Direskeneli Haner, Khan Md Saif Ullah
Department of Medicine, Nepal Medical College, Kathmandu, NPL.
Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD.
Cureus. 2025 Apr 17;17(4):e82459. doi: 10.7759/cureus.82459. eCollection 2025 Apr.
Digital ischemia (DI) is an uncommon condition. Information on the etiology of DI is limited. This study aimed to determine the diagnosis of DI in a tertiary care center in Bangladesh.
This cross-sectional study was conducted in the rheumatology department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from September 1, 2020, to August 31, 2021. A total of 25 consecutive patients with DI were enrolled. Each patient was assessed following the classification/diagnostic criteria for vasculitis and vasculopathy. The 2012 International Chapel Hill Consensus Conference on the Nomenclature of Vasculitides was used for case definition. The study subjects were divided into vasculitis and vasculopathy groups. Fisher's exact and Student's t-tests were used to compare the groups.
The mean age was 35.88 years with a female predominance (72%). Among 25 patients, 15 (60%) were in the vasculitis group and 10 (40%) in the vasculopathy group. Takayasu arteritis was found in one subject (4%), and another 14 had vasculitis associated with connective tissue diseases: 11 (44%) lupus vasculitis, two (8%) rheumatoid vasculitis, and one (4%) associated with dermatomyositis. In the vasculopathy group, five cases (20%) had systemic sclerosis (SSc), four (16%) had peripheral arterial disease (PAD), and one (4%) had primary antiphospholipid syndrome (APS). Fever (p=0.01), arthralgia/arthritis (p=0.01), and high CRP (p=0.04) were significantly associated with vasculitis.
In the hospital setting, connective tissue disease-associated vasculitis and SSc-related vasculopathy were the common causes of DI.
数字缺血（DI）是一种罕见病症。关于DI病因的信息有限。本研究旨在确定孟加拉国一家三级医疗中心对DI的诊断情况。
本横断面研究于2020年9月1日至2021年8月31日在孟加拉国达卡的班加班杜·谢赫·穆吉布医科大学（BSMMU）风湿病科进行。共纳入25例连续的DI患者。按照血管炎和血管病的分类/诊断标准对每位患者进行评估。采用2012年国际 Chapel Hill 血管炎命名共识会议的标准进行病例定义。研究对象分为血管炎组和血管病组。采用Fisher精确检验和学生t检验对两组进行比较。
平均年龄为35.88岁，女性占主导（72%）。25例患者中，15例（60%）在血管炎组，10例（40%）在血管病组。1例患者（4%）患有高安动脉炎，另外14例患有与结缔组织病相关的血管炎：11例（44%）为狼疮性血管炎，2例（8%）为类风湿性血管炎，1例（4%）与皮肌炎相关。在血管病组中，5例（20%）患有系统性硬化症（SSc），4例（16%）患有外周动脉疾病（PAD），1例（4%）患有原发性抗磷脂综合征（APS）。发热（p = 0.01）、关节痛/关节炎（p = 0.01）和高CRP（p = 0.04）与血管炎显著相关。
在医院环境中，结缔组织病相关血管炎和SSc相关血管病是DI的常见病因。
