Thomas Szewczyk, BS; Farzana Hoque, MD, MRCP, FRCP
WMJ. 2026;125(4):513-517. Published November 1, 2026.
ABSTRACT
Introduction: Catastrophic antiphospholipid syndrome (CAPS) is a rare, life-threatening variant of antiphospholipid syndrome marked by rapid multiorgan thrombosis. Early diagnosis remains challenging, especially in young adults.
Case Presentation: A 22-year-old woman with immune thrombocytopenia, Raynaud’s phenomenon, and a recent cholecystectomy presented with headache, abdominal pain, and systemic symptoms. She developed thrombotic events in the brain, spleen, and kidneys. Laboratory testing demonstrated positive antiphospholipid antibodies, and renal biopsy confirmed thrombotic microangiopathy.
Discussion: CAPS was diagnosed in the context of evolving systemic lupus erythematosus. Treatment included corticosteroids, plasma exchange, anticoagulation, hydroxychloroquine, and rituximab. Despite delayed recognition due to overlapping autoimmune conditions, multidisciplinary management led to clinical stabilization.
Conclusions: This case highlights the diagnostic complexity of CAPS in young patients with autoimmune comorbidities. Early recognition and aggressive multidisciplinary treatment are essential for favorable outcomes.