{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T06:33:10Z","timestamp":1782801190086,"version":"3.54.5"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:00:00Z","timestamp":1768003200000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Peripheral vascular disease (PVD) is a rare but severe symptom of CREST syndrome, which itself is a limited cutaneous sclerosis. Even though Raynaud's phenomenon is the gold standard of CREST, the development of critical limb ischemia and self\u2010amputation is rare. We report a case of a 48\u2010year\u2010old female with CREST syndrome who presented with progressive ischemia in both upper and lower limbs, leading to spontaneous auto\u2010amputation of multiple fingers\/toes. The patient exhibited sclerodactyly, dry gangrene, delayed capillary refill, and tactile deficits in peripheral pulses. ANA and anti\u2010Scl 70 antibody were positive. CT angiography demonstrated segmental and progressive obstruction of multifocal peripheral arteries. The patient was operated on for amputation of necrotic digits and was initiated on immunomodulatory therapy. Following treatment, monitoring revealed stabilization without further progression. This case highlights the possible seriousness of vascular complications in CREST syndrome. Prompt diagnosis and treatment are necessary to prevent irreversible ischemic damage.<\/jats:p>","DOI":"10.1002\/ccr3.71815","type":"journal-article","created":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T10:05:37Z","timestamp":1768039537000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Beyond Raynaud's: Atypical Peripheral Vascular Manifestations in a Case of\n                    <scp>CREST<\/scp>\n                    Syndrome"],"prefix":"10.1002","volume":"14","author":[{"given":"Sakshi","family":"Kumari","sequence":"first","affiliation":[{"name":"Shimoga Institute of Medical Sciences  Shimoga India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fathimathul","family":"Henna","sequence":"additional","affiliation":[{"name":"Dubai Medical College for Girls  Dubai UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0456-022X","authenticated-orcid":false,"given":"Umama","family":"Alam","sequence":"additional","affiliation":[{"name":"Khyber Medical College  Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0508-4765","authenticated-orcid":false,"given":"Fazia","family":"Khattak","sequence":"additional","affiliation":[{"name":"Khyber Medical College  Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8208-0689","authenticated-orcid":false,"given":"Kamil Ahmad","family":"Kamil","sequence":"additional","affiliation":[{"name":"Internal Medicine Department Mirwais Regional Hospital  Kandahar Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,10]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.303849"},{"issue":"11","key":"e_1_2_14_3_1","first-page":"1971","article-title":"Peripheral Vascular Disease: Diagnosis and Treatment","volume":"73","author":"Sontheimer D. L.","year":"2006","journal-title":"American Family Physician"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100031\u20101278323"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0049-3848(01)00366-8"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.320.7244.1262"},{"issue":"2","key":"e_1_2_14_7_1","first-page":"123","article-title":"A Review of Raynaud's Disease","volume":"113","author":"Temprano K. K.","year":"2016","journal-title":"Missouri Medicine"},{"key":"e_1_2_14_8_1","unstructured":"Mayo Clinic \u201cRaynaud's Disease\u2014Symptoms and Causes\u201d [Internet] https:\/\/www.mayoclinic.org\/diseases\u2010conditions\/raynauds\u2010disease\/symptoms\u2010causes\/syc\u201020363571."},{"key":"e_1_2_14_9_1","unstructured":"Healthline \u201cPeripheral Artery Disease Skin Changes: Symptoms and Causes\u201d [Internet] https:\/\/www.healthline.com\/health\/peripheral\u2010artery\u2010disease\u2010skin\u2010changes."},{"issue":"3","key":"e_1_2_14_10_1","first-page":"320","article-title":"Weight Loss Caused by Visceral Artery Disease","volume":"40","author":"Clifton W. L.","year":"2013","journal-title":"Texas Heart Institute Journal"},{"key":"e_1_2_14_11_1","unstructured":"Johns Hopkins Medicine \u201cPeripheral Vascular Disease\u201d [Internet] https:\/\/www.hopkinsmedicine.org\/health\/conditions\u2010and\u2010diseases\/peripheral\u2010vascular\u2010disease."},{"key":"e_1_2_14_12_1","unstructured":"PVD and Me \u201cSwelling (Edema) and Peripheral Vascular Disease\u201d [Internet] https:\/\/www.pvdandme.com\/homepage\/pvd\u2010symptoms\/swelling\u2010edema.html."},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2012.96"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1507638"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lpm.2021.104064"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.71815","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.71815","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.71815","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T07:18:01Z","timestamp":1769066281000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.71815"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1002\/ccr3.71815"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.71815","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-04-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71815"}}