Symmetrical peripheral gangrene

Acute ischemia with gangrene, permanent cyanosis, and/or Raynaud's phenomenon.

Catecholamine-requiring cardiogenic shock (maximum catecholamine dose 3µg/kg/min). These changes are discussed as cutaneous markers of a consumption coagulopathy.

Paraneoplastic as "Paraneoplastic Acral Vascular Syndrome" , PAVS. Formation of procoagulant substances by the neoplasm. Associated with neoplasms of the lung, ovary, and uterus (Kopterides P et al. 2004; Mittal A et al. (2017).

Cryoglobulins are also pathogenetically blamed. Furthermore, tumor emboli can induce acral vascular occlusions.

1. Kopterides P et al (2004) Digital gangrene and Raynaud's phenomenon as complications of lung adenocarcinoma. Lancet Oncol 5:549.
2. Lai TS et al (2020) Paraneoplastic Raynaud's phenomenon associated with metastatic ovarian cancer: A case report and review of the literature. Gynecol Oncol Rep 33:100575.
3. Lokineni S et al (2021) Paraneoplastic Raynaud's phenomenon as an initial manifestation of lung cancer? Eur J Case Rep Intern Med 8:002690
4. Macheka KT et al (2020) Symmetrical peripheral gangrene: A rare clinical entity. Clin Case Rep 8: 2914-2917.
5. Mittal A et al (2017) Carcinoma of Unknown Primary Presenting as Peripheral Symmetric Gangrene. J Assoc Physicians India 65:78-81.
6. Schuh TE et al (2002) Symmetric peripheral gangrene of unknown etiology. The Surgeon 73: 638-641