The concomitant expression of vasculitis and coagulopathy: synergy for marked tissue ischemia.

We describe 4 patients with coagulopathy and vasculitis that demonstrated marked tissue ischemia and necrosis. In the clinical setting of rapid evolution of vascular insufficiency, the possibility of combined vasculopathic processes should be considered. This is especially so in patients with underlying connective tissue disease such as systemic lupus erythematosus or rheumatoid arthritis, in which both vasculitis and antiphospholipid antibodies are frequently present. Treatment of both pathologic processes may be required to prevent progressive tissue ischemia and necrosis. The use of antiplatelet and/or anticoagulation should be given consideration in addition to immunosuppressive agents.