Abstract
Catastrophic anti-phospholipid syndrome (CAPS) is characterized by microvascular thrombosis
in multiple sites leading to multi-organ damage. It is a rare and fatal complication
of antiphospholipid syndrome (APS). We present a rare case of CAPS that presented
with bilateral (b/l) adrenal hemorrhage making the diagnosis challenging in this otherwise
rare disease. A 51-year-old female was initially admitted with abdominal pain and
found to have bilateral adrenal hemorrhage. Patient had a fulminant disease course
in which she had thrombotic manifestations involving multiple organ systems. This
case was especially challenging as the patient's bilateral adrenal hemorrhage was
the first manifestation of CAPS; the diagnosis of APS had to be made while treatment
for presumed CAPS was emergently commenced for this life-threatening disease. Key
to managing this condition is having a high index of suspicion for the diagnosis in
patients presenting with multi-organ failure and multiple thromboses and hemorrhage.
Key Indexing Terms
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Article info
Publication history
Published online: August 28, 2022
Accepted:
August 19,
2022
Received:
March 11,
2022
Identification
Copyright
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
