Lupus vasculitis: differential diagnosis with antiphospholipid syndrome

The inflammatory process of systemic lupus erythematosus (SLE) vasculitis occurs in up to 56% of patients with SLE, whereas the vaso-occlusive incidence of antiphospholipid syndrome in SLE (which is not exclusive of SLE vasculitis) reaches up to 15%. Both situations can be life-threatening, requiring the appropriate therapeutic approach. Aggressive anti-inflammatory therapy is used in the case of SLE vasculitis and aggressive antithrombotic/anticoagulant treatment in the other. However, often the differential diagnosis between the two entities is difficult to achieve, especially when a tissue biopsy to help establish the diagnosis is topographically difficult to obtain or is clinically contraindicated. Such situations are discussed and appropriate guidelines for a correct diagnosis suggested.