Multifocal Osteonecrosis in a Patient With Systemic Lupus Erythematosus and Antiphospholipid Syndrome Associated With Pyoderma Gangrenosum and Other Complications: A Case Report.

Systemic lupus erythematosus (SLE) is a quintessential illustration of an autoimmune disease. It results from complex interactions that include impaired apoptotic clearance, increased activity of both the innate and adaptive immune systems, complement activation, the development of immune complexes, and ensuing tissue inflammation, which collectively contribute to a sustained autoimmune response. We present a case relating to a 37-year-old female patient (from Ardabil, Iran) who received a diagnosis of SLE and antiphospholipid syndrome (APS), in accordance with established diagnostic criteria. She is currently admitted to the hospital due to a recurring pyoderma gangrenosum ulcer, accompanied by pain and swelling in her left leg. The patient tested positive for ANA, lupus anticoagulant, anti-beta2-glycoprotein I (anti-beta2GPI), and anti-Ro antibodies. These results, along with her clinical manifestations such as spontaneous abortion, stroke, malar rash, photosensitivity, and pyoderma gangrenosum ulcers, confirm a diagnosis of SLE associated with APS according to the relevant criteria. After appropriate medical treatment, she was identified as experiencing a lupus flare and multifocal osteonecrosis in the knee, hip, and shoulder.