Probable catastrophic antiphospholipid syndrome (CAPS)

We  describe  the  case  of  a  53-year-old  man  who  presented  with  a cerebellar stroke. He developed a thrombus in his left ileo-femoral vein, and his IgG anticardiolipin antibody turned out to be positive. He then developed thrombosis of  the  right  ileo-femoral  vein  while  well  anticoagulated  with  warfarin.  Despite aggressive  anticoagulation  he  developed  livedo  reticularis,  pulmonary  embolism, adult  respiratory  distress  syndrome  and  renal  failure  over  a  few  weeks  and eventually died from a large gastrointestinal bleeding. He probably had catastrophic antiphospholipid  syndrome  (CAPS)  or  Asherson’s  syndrome,  which  has  a  high mortality. We discuss the current treatment options available for such a patient.