Year: 2026
Type: article
Study design: Case Report
Abstract: Catastrophic antiphospholipid syndrome (CAPS) is an uncommon but often fatal manifestation of antiphospholipid syndrome, marked by rapid, diffuse microvascular thrombosis with multiorgan involvement. In practice, the initial clinical picture can be indistinguishable from severe infection or sepsis-associated organ failure, which makes early diagnosis challenging. Early recognition is critical, as delayed intervention is associated with high mortality. We report a case of probable CAPS that presented with splenic infarction and shock in the setting of suspected sepsis. Her condition progressed quickly to multiorgan dysfunction, and antiphospholipid antibody testing repeatedly showed high-titer triple positivity. After probable CAPS was considered, triple therapy (high-dose glucocorticoids, anticoagulation, and therapeutic plasma exchange) was initiated, and she was discharged after clinical stabilization. She was later readmitted with fulminant infection and recurrent CAPS-like manifestations. Anticoagulation and plasma exchange were not restarted, and she died within 72 h, highlighting two contrasting courses under diagnostic uncertainty.
Source: Frontiers in Medicine
Authors: Sheng-Jie Hou, Ming-Xin Xie, Xuanlin Feng, Hua Jiang, Ping Zhou
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7154263634