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Antiphospholipid syndrome — SCE Rheumatology MCQ

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HardConnective tissue diseasesAntiphospholipid syndromeSCE Rheumatology

Catastrophic antiphospholipid syndrome is strongly suspected with multiorgan thrombosis developing over days. Which initial combination is most appropriate?

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Correct answer: E — Therapeutic heparin, high-dose glucocorticoid and plasma exchange or IVIg

CAPS treatment is started urgently with full anticoagulation and high-dose glucocorticoid plus plasma exchange and/or IVIg. Triggers such as infection are treated, and cyclophosphamide is added when active SLE is driving the syndrome.

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