SAT-575 Rare Coexistence of Antiphospholipid Syndrome & New-Onset Diabetes Mellitus in Acute Limb-Threatening Ischemia

Abstract Disclosure: M.G. Famorcan: None. J.G. Sazon: None. M.S. Gomez: None. J.P. de Leon: None. J.Z. Lacson: None. F.C. Yap: None. J.I. Dela Cruz: None. B.M. Baluga: None. Background: Acute limb ischemia (ALI) is a sudden reduction in blood flow to the limbs, causing tissue damage. Embolic ALI occurs abruptly, while thrombotic ALI develops gradually in patients with peripheral arterial disease (PAD). Antiphospholipid syndrome (APS), marked by antiphospholipid antibodies, can lead to thrombosis, limb loss, & pregnancy complications. Diabetes mellitus (DM) exacerbates atherothrombosis via inflammation, hypercoagulability, & vascular damage. We report a rare case of Rutherford Type 2B ALI in a young woman with recurrent pregnancy losses & new-onset hyperglycemia, successfully managed with urgent revascularization.Case Presentation: A 27-year-old woman with chronic gestational hypertension & multiple miscarriages presented with progressive left index finger symptoms after an injury, including pain, swelling, discoloration, severe nocturnal pain, and eventual necrosis. She then developed intermittent left calf pain worsening with walking, extending to her foot & lower leg. Examination revealed a cold, violaceous left foot with absent pulses in the femoral, popliteal, posterior tibial, anterior tibial, & dorsalis pedis arteries. Doppler signals were not appreciated, & random blood glucose was 310 mg/dL, prompting insulin drip initiation. The patient received bolus dose of heparin followed by a continuous infusion. Emergency embolectomy with on-table angiography and vein patch repair of the left common femoral artery was performed. Intraoperative findings revealed thrombi in the common, superficial, & deep femoral arteries, which were successfully evacuated, resolving the symptoms. Histopathology confirmed thromboembolus, & lupus anticoagulant positivity indicated APS (LA1 51.2 sec, LA2 38.1 sec, LA ratio 1.3), while cardiolipin and B2-glycoprotein antibodies were negative. Conclusion: The rare coexistence of APS & new-onset diabetes significantly increased the patient’s risk of ALI. Timely diagnosis & urgent revascularization were critical in preventing limb loss & achieving a favorable outcome. Presentation: Saturday, July 12, 2025