Morning Report: Catastrophic Antiphospholipid Syndrome “aka “CAPS”

aps

Thank you Dr. Sarkisyan for an excellent case of CAPS on 11/20/15!

Teaching Points:

  • CAPS: The most severe form of APS, an acute biologic process that leads to occlusion of vessels of multiple organs.
    • Clotting gone wild!
    • MUST NOT MISS Diagnosis: High mortality rate (30-50%)
  • Diagnosis requires acute (<1 week) onsets of symptoms, 3 or more organ involvement, APL antibodies, and biopsy confirmation of small vessel occlusion
  • Infections are most common precipitating factors
  • Think about this dx in any patient p/w anemia and thrombocytopenia (MAHA) with evidence of end organ dysfunction (ie. Chest pain, SOB, AKI, HTN, Stroke, DVT/PE, etc)
  • Treatment: Anticoagulation, High-dose glucocorticoids, Plasma exchange