Getting to the Heart of the Matter

A 21-year-old Hispanic woman presented with a history of spontaneous miscarriage developed palpable purpura and transient visual loss followed by permanent vision loss OD, secondary to a central retinal artery occlusion with concomitant optic disk edema. The differential diagnosis for vascular occlusion in systemic lupus erythematosus includes antiphospholipid antibody, systemic lupus erythematosus-related vasculitis, hypercoaguable state, or Libman-Sachs endocarditis.