Systemic Lupus Erythematosus with Initial Symptoms of Extensive Digital Gangrene: A Case Report

Systemic lupus erythematosus (SLE) is a chronic, diffuse connective tissue disease primarily caused by the abnormal activation of the immune system, leading to autoimmune attacks on the body's own tissues. Circulatory disorders resulting in gangrene of the extremities as an initial complication of SLE are exceedingly rare. This case report describes a 23-year-old Asian female who was admitted with severe gangrenous involvement of both hands and the right lower extremity. She tested positive for multiple autoantibodies and was diagnosed with SLE, although she lacked other typical signs or symptoms of the disease. Treatment included methylprednisolone, hydroxychloroquine, and plasma exchange; however, these interventions failed to halt the progression of terminal gangrene, necessitating amputation. This case highlights the rarity and poor prognosis associated with SLE presenting with extremity gangrene. Immediate and aggressive treatment is imperative for better outcomes.