The Wolf Hidden behind the Clots: Catastrophic Antiphospholipid Antibody Syndrome
Catastrophic antiphospholipid syndrome (CAPS) is a rare but highly fatal clinical syndrome that occurs in up to 1% of patients with antiphospholipid syndrome (APS). The diagnosis of CAPS is often delayed because its presentation with multiple organ thromboses can be confused with other thrombotic mi...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2018/4693037 |
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| author | Myat Han Soe Krishna Adit Agarwal Alueshima Akough-Weir |
| author_facet | Myat Han Soe Krishna Adit Agarwal Alueshima Akough-Weir |
| author_sort | Myat Han Soe |
| collection | DOAJ |
| description | Catastrophic antiphospholipid syndrome (CAPS) is a rare but highly fatal clinical syndrome that occurs in up to 1% of patients with antiphospholipid syndrome (APS). The diagnosis of CAPS is often delayed because its presentation with multiple organ thromboses can be confused with other thrombotic microangiopathies and severe sepsis. We report a case of CAPS in a patient with APS and systemic lupus erythematosus (SLE) presenting with thrombotic storm precipitated by trauma, cytomegalovirus (CMV) infection, and noncompliance with anticoagulation therapy. Our case reflects the “two-hit hypothesis” of APS in which the presence of antiphospholipid antibodies (first hit) increases the thrombophilic risk, and thromboses take place in the presence of another thrombophilic condition such as CMV infection in our case. In this case review, we discuss the diagnostic challenges and management of CAPS. In clinical practice, we aim to stress the importance of thorough evaluation and management of precipitating events such as infections in addition to timely diagnosis and treatment of this catastrophic clinical entity. |
| format | Article |
| id | doaj-art-ec3b7cbb4e7e480e84f2a67ec5a32387 |
| institution | DOAJ |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-ec3b7cbb4e7e480e84f2a67ec5a323872025-08-20T03:21:24ZengWileyCase Reports in Medicine1687-96271687-96352018-01-01201810.1155/2018/46930374693037The Wolf Hidden behind the Clots: Catastrophic Antiphospholipid Antibody SyndromeMyat Han Soe0Krishna Adit Agarwal1Alueshima Akough-Weir2Department of Medicine, Baystate Medical Center, University of Massachusetts Medical School, Springfield, MA, USADepartment of Medicine, Baystate Medical Center, University of Massachusetts Medical School, Springfield, MA, USADepartment of Medicine, Baystate Medical Center, University of Massachusetts Medical School, Springfield, MA, USACatastrophic antiphospholipid syndrome (CAPS) is a rare but highly fatal clinical syndrome that occurs in up to 1% of patients with antiphospholipid syndrome (APS). The diagnosis of CAPS is often delayed because its presentation with multiple organ thromboses can be confused with other thrombotic microangiopathies and severe sepsis. We report a case of CAPS in a patient with APS and systemic lupus erythematosus (SLE) presenting with thrombotic storm precipitated by trauma, cytomegalovirus (CMV) infection, and noncompliance with anticoagulation therapy. Our case reflects the “two-hit hypothesis” of APS in which the presence of antiphospholipid antibodies (first hit) increases the thrombophilic risk, and thromboses take place in the presence of another thrombophilic condition such as CMV infection in our case. In this case review, we discuss the diagnostic challenges and management of CAPS. In clinical practice, we aim to stress the importance of thorough evaluation and management of precipitating events such as infections in addition to timely diagnosis and treatment of this catastrophic clinical entity.http://dx.doi.org/10.1155/2018/4693037 |
| spellingShingle | Myat Han Soe Krishna Adit Agarwal Alueshima Akough-Weir The Wolf Hidden behind the Clots: Catastrophic Antiphospholipid Antibody Syndrome Case Reports in Medicine |
| title | The Wolf Hidden behind the Clots: Catastrophic Antiphospholipid Antibody Syndrome |
| title_full | The Wolf Hidden behind the Clots: Catastrophic Antiphospholipid Antibody Syndrome |
| title_fullStr | The Wolf Hidden behind the Clots: Catastrophic Antiphospholipid Antibody Syndrome |
| title_full_unstemmed | The Wolf Hidden behind the Clots: Catastrophic Antiphospholipid Antibody Syndrome |
| title_short | The Wolf Hidden behind the Clots: Catastrophic Antiphospholipid Antibody Syndrome |
| title_sort | wolf hidden behind the clots catastrophic antiphospholipid antibody syndrome |
| url | http://dx.doi.org/10.1155/2018/4693037 |
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