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Catastrophic antiphospholipid syndrome — SCE Acute Medicine MCQ

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ModerateAcute Rheumatological and Dermatological EmergenciesCatastrophic antiphospholipid syndromeSCE Acute Medicine

A 55-year-old man presents with rash, allergic features, visual symptoms or systemic inflammation. Relevant history includes recent drug exposure, autoimmune disease or allergen exposure. On assessment, skin, mucosal or vascular findings suggest systemic disease. Investigations show rapid multiorgan thrombosis in known antiphospholipid syndrome. What is the most likely diagnosis?

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Correct answer: B — Catastrophic antiphospholipid syndrome

The key discriminator is that rapid multiorgan thrombosis in known antiphospholipid syndrome, which makes Catastrophic antiphospholipid syndrome the single best answer. Pulmonary embolism is less appropriate because it does not address the dominant acute risk in the vignette; Vasculitic pulmonary-renal syndrome would fit a different presentation or later stage of care. Bacterial meningitis and Anaphylaxis are suboptimal because they would either delay time-critical treatment or follow the wrong acute pathway. Teaching point: SCE-style acute medicine questions usually test prioritisation using physiology, timing and a guideline-defined threshold, rather than isolated factual recall.

Reference: EULAR APS recommendations