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Catastrophic antiphospholipid syndrome — SCE Rheumatology MCQ

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HardConnective Tissue DiseasesCatastrophic antiphospholipid syndromeSCE Rheumatology

A patient with triple-positive antiphospholipid syndrome develops renal, cerebral, pulmonary and adrenal thromboses over four days with thrombocytopenia. What is the diagnosis?

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Correct answer: D — Catastrophic antiphospholipid syndrome with multiorgan thrombosis

Rapid thrombosis in at least three organ systems in a patient with persistent antiphospholipid antibodies is catastrophic APS. Infection, TTP, DIC and complement-mediated microangiopathy are urgent mimics, but treatment begins quickly when CAPS is strongly suspected.

Reference: BSH guideline on investigation and management of antiphospholipid syndrome (Published July 2024; reviewed August 2025): https://cms.b-s-h.org.uk/guidelines/guidelines/guidelines-on-the-investigation-and-management-of-antiphospholipid-syndrome; EULAR recommendations for management of antiphospholipid syndrome (Published 2019): https://ard.bmj.com/content/78/10/1296