Ischemic limb necrosis results from thrombosis or thromboembolism involving limb arteries with or without loss of arterial pulses.
Ischemic limb gangrene can result from thrombosis involving the microcirculation including small venules.
Also associated with atherosclerotic and connective tissue disease process.
Can be associated with presentation of malignant neoplasm,particularly of a lymphoproliferative type.
Two syndromes of microthrombosis associated ischemic limb injury include venous limb gangrene complicating thrombocytopenic disorders that are strongly associated with deep vein thrombosis and heparin-induced thrombocytopenia.
In the above micro thrombosis conditions, microthrombosis occurs in the same limb as the acute large vein thrombosis resulting in acral ischemic necrosis.
Usually only one limb is affected with the large vein thrombosis and associated microthrombosis.
Occasionally all four limbs are affected in symmetrical peripheral gangrene featuring acral limb ischemic necrosis but without deep vein thrombosis.
Initial studies include CBC, test for inflammatory markers, ANA antibodies, and a measurement of cryoglobulin concentration.