A Case of Catastrophic Antiphospholipid Syndrome Presenting as Pulmonary Embolism and Renal Thrombosis: A Case Report and Literature Review

Abstract

Catastrophic antiphospholipid syndrome (CAPS), also known as Asherson’s syndrome, is a rare and life-threatening condition that represents the most severe clinical manifestation of antiphospho lipid syndrome. Due to its rapid and aggressive course, CAPS is characterized by the development of widespread micro- and macrothrombosis, which results in multi-organ ischemia and failure. Antiphospholipid syndrome, an autoimmune disorder, is characterized by thrombotic and/or obstet ric events, accompanied by persistent antiphospholipid antibodies. The case of a 36-year-old woman was described, who initially presented with low-effort dyspnea and abdominal pain, with subsequent imaging revealing pulmonary embolism and aortic thrombosis, alongside acute ischemic cerebellar infarcts. The eventual confirmation of a positive lupus anticoagulant solidified the diagnosis of CAPS. This case underscores the diagnostic challenge posed by CAPS, particularly when presenting with prominent pulmonary embolism, and highlights the critical need for prompt recognition and mul tidisciplinary management. Furthermore, the patient’s positive outcome demonstrates the potential for recovery even in such severe presentations.

Cite this article as: Maradiaga FA, Diaz VS, Rubio MA, Arias JP, Alas-Pineda C. A case of catastrophic antiphospholipid syndrome presenting as pulmonary embolism and renal thrombosis: a case report and literature review. Eur J Rheumatol. 2025, 12(4), 0018, doi:10.5152/eurjrheum.2025.25018.