A STUDY OF COAGULATION AND ANTIENDOTHELIAL ANTIBODIES IN IDIOPATHIC LIVEDO-RETICULARIS

Livedo reticularis is associated with collagen vascular diseases and o ther vaso-occlusive disorders in a substantial number of cases. In the remaining cases the cause of livedo reticularis is still unknown (i.e . idiopathic). We sought to determine a possible causal relationship b etween idiopathic livedo reticularis and autoimmune factors associated with the coagulation system, including antiendothelial cell antibodie s. Nine patients with idiopathic livedo reticularis were studied. All patients mere found to have normal platelet count, fibrinogen levels, and prothrombin and activated partial thromboplastin times, as well as negative results for Venereal Disease Research Laboratory and D-timer tests. Anticoagulant activity was detected in 2 patients: one had pos itive results of thromboplastin titration index and Russell's viper ve nom test, as well as increased levels of anticardiolipin antibodies an d anti-endothelial cell antibodies; the other has positive thromboplas tin titration index, mildly increased levels of anti-endothelial cell antibodies, and markedly increased level of antinuclear antibodies. A third patient had mildly increased levels of antiendothelial cell anti bodies alone, and a fourth patient had mildly increased levels of anti nuclear antibodies only. The clinical outcome was uneventful in all of the patients during an 18-month follow-up period. These findings sugg est involvement of autoimmune factors associated with the coagulation system in some patients with idiopathic livedo reticularis, whose clin ical significance remains to be determined.