DOI: 10.36347/sjmcr.2018.v06i09.013

Pages: 656-659

Phlegmasia cerulea dolens (PCD) is a rare and critical complication of deep vein thrombosis (DVT) that results from extensive thrombotic occlusion of the major and collateral veins of an extremity, which back up into the arterial vasculature causing limb cyanosis then eventual gangrene and limb death. The prompt recognition of this condition is crucial to prevent progression of clot burden resulting in surgical intervention. Doppler ultrasound investigation of both venous and arterial vasculature is used to determine DVT. Any cause of DVT, both provoked or unprovoked can lead to PCD. Once identified, anticoagulation must be started immediately. A common rheumatologic condition such as Systemic Lupus Erythematosus (SLE) is known to cause coagulopathies and thrombosis, but currently PCD being a presenting symptom of SLE has not yet been documented in literature. We describe a case where PCD is the presenting manifestation of SLE and highlight the need for rapid recognition to prevent irreparable limb damage.