{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:12:45Z","timestamp":1777929165712,"version":"3.51.4"},"reference-count":15,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T00:00:00Z","timestamp":1719360000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001407","name":"Department of Biotechnology, Ministry of Science and Technology, India","doi-asserted-by":"publisher","award":["[BT\/PR23111\/MED\/30\/1852\/2017]"],"award-info":[{"award-number":["[BT\/PR23111\/MED\/30\/1852\/2017]"]}],"id":[{"id":"10.13039\/501100001407","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>There is limited literature on digital ischemia in systemic Lupus erythematosus (SLE). We report the prevalence, associations and outcome of digital infarcts and gangrene from the Indian SLE inception cohort (INSPIRE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From the web-based database of INSPIRE, we extracted information for patients with \u2018Digital Infarct\u2019 and \u2018Digital gangrene\u2019 at enrolment into cohort, together considered as critical peripheral ischemia (CPI); all others were controls. We describe the associations of CPI with SLE clinical phenotype, autoantibodies, and disease activity at enrolment. We also report short term outcomes viz. Digital tissue loss and early mortality up to 6 months and recurrence of digital ischemic events in cases till date.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 2503 SLE patients enrolled into the INSPIRE cohort, we identified 75 (2.9%) patients with CPI, 72 (96%) women and 6 (8%) children. Of them, 55 (73.3%) had digital gangrene and 21 (28%) patients had digital infarcts. Majority of digital gangrene resulted in amputation distal to terminal phalanx (63.6%). Multivariable analysis showed that pulmonary hypertension AOR [6.34 (1.99, 20.2)], coexistent thrombosis AOR [27.8 (15.7, 48.7)], triple antiphospholipid antibody positivity AOR [5.36 (1.67, 16.9)] and the presence of anti-Scl-70-antibody AOR [5.59 (1.86, 16.7)] were more likely while patients with class 3 or 4 lupus nephritis AOR [0.37 (0.15, 0.95)] and anti-nucleosome antibodies AOR [0.47 (0.23, 0.99)] were less likely to be associated with CPI. SLEDAI and short-term mortality were similar between cases and controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CPI occurred in a higher proportion (2.9%) of SLE patients in the INSPIRE cohort as compared to earlier reports. Both prothrombotic state and vasculopathy contribute to its occurrence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09612033241263232","type":"journal-article","created":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T11:55:48Z","timestamp":1719402948000},"page":"974-978","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Critical peripheral ischemia: Higher prevalence in Indian systemic lupus erythematosus inception cohort for research (INSPIRE)"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5271-0766","authenticated-orcid":false,"given":"Vineeta","family":"Shobha","sequence":"first","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, St John\u2019s Medical College Hospital, Bengaluru, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9789-9985","authenticated-orcid":false,"given":"Liza","family":"Rajasekhar","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology & Rheumatology, Nizam Institute of Medical Sciences, Hyderabad, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Manuel","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, St John\u2019s Medical College Hospital, Bengaluru, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nayana","family":"V","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, St John\u2019s Medical College Hospital, Bengaluru, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3965-5410","authenticated-orcid":false,"given":"Ranjan","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saumya Ranjan","family":"Tripathy","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, SCB Medical College, Cuttack, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parasar","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, Institute of Postgraduate Medical Education & Research, Kolkata, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3643-3989","authenticated-orcid":false,"given":"Chengappa","family":"Kavadichanda","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education& Research, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashish J","family":"Mathew","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology & Rheumatology, Christian Medical College, Vellore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2642-8895","authenticated-orcid":false,"given":"Manish","family":"Rathi","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avinash","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, SMS Medical College & Hospital, Jaipur, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumitra","family":"Selvam","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics, St John\u2019s Research Institute, St John\u2019s Medical College Hospital, Bengaluru, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2187-5186","authenticated-orcid":false,"given":"Amita","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,6,26]]},"reference":[{"key":"bibr1-09612033241263232","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1962.03050310006002"},{"key":"bibr2-09612033241263232","doi-asserted-by":"publisher","DOI":"10.1177\/09612033231177788"},{"key":"bibr3-09612033241263232","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ken210"},{"key":"bibr4-09612033241263232","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ken451"},{"key":"bibr5-09612033241263232","doi-asserted-by":"publisher","DOI":"10.1177\/0961203309106643"},{"key":"bibr6-09612033241263232","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2016.05.087"},{"key":"bibr7-09612033241263232","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-020-04766-3"},{"key":"bibr8-09612033241263232","doi-asserted-by":"publisher","DOI":"10.1002\/art.34473"},{"key":"bibr9-09612033241263232","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-0658"},{"key":"bibr10-09612033241263232","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-3083.2000.00120.x"},{"issue":"1","key":"bibr11-09612033241263232","first-page":"50","volume":"42","author":"Ha-Ou-Nou 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