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We review and synthesize how an environmental insult (exposure to extreme cold for a short duration) and endogenous (antiphospholipid antibody syndrome, SLE vasculitis) insults in a susceptible young female with lupus (peripheral arterial disease, smoking, SLE) led to a perfect storm resulting in catastrophic injuries (frostbite).<\/jats:p>","DOI":"10.1177\/0961203314530485","type":"journal-article","created":{"date-parts":[[2014,4,3]],"date-time":"2014-04-03T21:59:16Z","timestamp":1396562356000},"page":"837-839","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Lupus \u2013 the cold, hard facts"],"prefix":"10.1177","volume":"23","author":[{"given":"NWK","family":"Wong","sequence":"first","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Canada; 2Department of Medicine, University of Toronto, Toronto, Canada; 3Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Canada; and 4Toronto Western Hospital, University Health Network, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"VT-Y","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Canada; 2Department of Medicine, University of Toronto, Toronto, Canada; 3Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Canada; and 4Toronto Western Hospital, University Health Network, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Canada; 2Department of Medicine, University of Toronto, Toronto, Canada; 3Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Canada; and 4Toronto Western Hospital, University Health Network, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Slessarev","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Canada; 2Department of Medicine, University of Toronto, Toronto, Canada; 3Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Canada; and 4Toronto Western Hospital, University Health Network, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Chandran","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Canada; 2Department of Medicine, University of Toronto, Toronto, Canada; 3Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Canada; and 4Toronto Western Hospital, University Health Network, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2014,4,3]]},"reference":[{"key":"bibr1-0961203314530485","doi-asserted-by":"crossref","first-page":"57","DOI":"10.20452\/pamw.306","volume":"118","author":"Cie\u015blik P","year":"2008","journal-title":"Pol Arch Med Wewn\u0119trznej"},{"key":"bibr2-0961203314530485","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.548495"},{"key":"bibr3-0961203314530485","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200812000-00003"},{"key":"bibr4-0961203314530485","first-page":"305","volume":"168","author":"Biem J","year":"2003","journal-title":"CMAJ"},{"key":"bibr5-0961203314530485","doi-asserted-by":"publisher","DOI":"10.3402\/ijch.v63i1.17650"},{"key":"bibr6-0961203314530485","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-008-0942-9"}],"container-title":["Lupus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0961203314530485","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0961203314530485","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0961203314530485","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:14:28Z","timestamp":1777677268000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0961203314530485"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4,3]]},"references-count":6,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2014,7]]}},"alternative-id":["10.1177\/0961203314530485"],"URL":"https:\/\/doi.org\/10.1177\/0961203314530485","relation":{},"ISSN":["0961-2033","1477-0962"],"issn-type":[{"value":"0961-2033","type":"print"},{"value":"1477-0962","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,4,3]]}}}