The Rheumatologist
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
  • Technology
    • Electronic Health Records
    • Apps
    • Information Technology
  • Resources
    • Issue Archives
    • Events
    • Multimedia
      • Audio
      • Video
    • From the College
    • American College of Rheumatology
    • Rheumatology Research Foundation
    • Arthritis & Rheumatology
    • Arthritis Care & Research
    • Treatment Guidelines
    • Research Reviews
    • Annual Meeting
      • Abstracts
      • Meeting Reports
    • Rheumatology Image Bank
    • ACR ExamRheum
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / Catastrophic Antiphospholipid Syndrome with Pulmonary Hemorrhage: A Case Report

Catastrophic Antiphospholipid Syndrome with Pulmonary Hemorrhage: A Case Report

August 17, 2015 • By Joy-Ann Tabanor, MD, Hyun Bae, MD, Girish Sonpal, MD, & Karlene Williams, MD

  • Tweet
  • Email
Print-Friendly Version / Save PDF
More than one in three patients with CAPS will die. Thus, aggressive treatment is imperative.

More than one in three patients with CAPS will die. Thus, aggressive treatment is imperative.
Image Credit: Dragon Images/shutterstock.com

Thrombocytopenia is found in nearly half of patients with CAPS and would not account for bleeding until the count is less than 50,000/cubic millimeters. When present, concomitant DIC should be ruled out, because this condition would require transfusions of fresh frozen plasma and platelets. The benefit of transfusions of fresh frozen plasma in the bleeding patient with CAPS without any evidence of a factor deficiency or DIC has not been established, but should be considered in the case of large-volume blood transfusions because of the dilutional effect on clotting factors.

You Might Also Like
  • Rheumatology Case Report: TINU Syndrome with Concomitant Synovitis
  • ACR/ARHP Annual Meeting 2012: Tips to Diagnose and Treat Catastrophic Antiphospholipid Syndrome (CAPS)
  • Fellows’ Forum Case Report: Palmar Fasciitis & Polyarthritis Syndrome
Explore This Issue
August 2015

The precise mechanism by which APS causes pulmonary alveolar hemorrhage (PAH) has not been determined. In the largest case series of PAH in primary APS, lung biopsy specimen showed capillaritis and BAL fluid analysis revealed neutrophils and macrophages in keeping with an inflammatory cause of pulmonary hemorrhage. Anticoagulation, the first line in the treatment of CAPS, is contraindicated in these cases.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Conclusion

CAPS is rare, but it carries a high mortality rate. Pulmonary hemorrhage in particular is associated with a poor prognosis.4 Our case highlights the importance of increased awareness of the varied manifestations of this disease and the importance of aggressive treatment.


Dr. Tabanor

Dr. Tabanor

Joy-Ann Tabanor, MD, is the corresponding author, and a second-year resident physician in the Department of Medicine at Englewood Hospital and Medical Center in Englewood, N.J. She aspires to become a clinical rheumatologist.
Hyun Bae, MD, is a third-year resident physician in the Department of Medicine at Englewood Hospital and Medical Center in Englewood, N.J.
Girish Sonpal, MD, is a rheumatologist with decades of experience who practices in Whitestone, N.Y.
Karlene Williams, MD, is the associate program director for the Internal Medicine Residency Program at Englewood Hospital and Medical Center in Englewood, N.J.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

References

  1. Cervera R, Espinosa G. Update on the catastrophic antiphospholipid syndrome and the ‘CAPS Registry.’ Semin Thromb Hemost. 2012 Jun;38(4):333–338. doi.
  2. Erkan D, Schur P. Diagnosis of the antiphospholipid syndrome. In: Pisetsky, D, ed. UpToDate. Waltham, Mass.: UpToDate; 2015. Accessed April 14, 2015.
  3. Shapira I, Andrade D, Allen SL, et al. Brief report: Induction of sustained remission in recurrent catastrophic antiphospholipid syndrome via inhibition of terminal complement with eculizumab. Arthritis Rheum. 2012 Aug;64(8):2719–2723.
  4. Cartin-Ceba R, Peikert T, Ashrani A, et al. Primary antiphospholipid syndrome-associated diffuse alveolar hemorrhage. Arthritis Care Res (Hoboken). 2014 Feb;66(2):301–310.

Pages: 1 2 3 4 5 | Single Page

Filed Under: Conditions, Systemic Inflammatory Syndromes Tagged With: catastrophic antiphospholipid syndrome, Clinical, Diagnosis, hemorrhage, outcome, patient care, PulmonaryIssue: August 2015

You Might Also Like:
  • Rheumatology Case Report: TINU Syndrome with Concomitant Synovitis
  • ACR/ARHP Annual Meeting 2012: Tips to Diagnose and Treat Catastrophic Antiphospholipid Syndrome (CAPS)
  • Fellows’ Forum Case Report: Palmar Fasciitis & Polyarthritis Syndrome
  • Fellow’s Forum Case Report: When Pulmonary Symptoms Point to Rheumatic Disease

American College of Rheumatology

Visit the official website for the American College of Rheumatology.

Visit the ACR »

ACR/ARP Annual Meeting

Don’t miss rheumatology’s premier scientific meeting for anyone involved in research or the delivery of rheumatologic care or services.

Visit the ACR Annual Meeting site »

Rheumatology Research Foundation

The Foundation is the largest private funding source for rheumatology research and training in the U.S.

Learn more »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2019 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.