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April 14, 2026Journal of Cardiothoracic Surgery0 citationsOpen Access

From hemoptysis to thrombosis: a comprehensive case study of catastrophic antiphospholipid syndrome in a young female

ASAdriana J. SkafiAAAlaa A. AdawiMBMays Y. Butmah

Key Points

  • The case aims to illustrate the aggressive characteristics and diagnostic challenges of catastrophic antiphospholipid syndrome (CAPS).
  • Detailed examination of a young female with CAPS and hemoptysis.
  • Systematic exclusion of mimics when histopathology is not possible.
  • Implementation of early triple therapy with rituximab in severe cases.
  • CAPS was identified as aggressive with unusual presentations including large-vessel cardiac extension.
  • The early use of triple therapy was critical in managing the condition effectively.

Abstract

This case provides key learning points, underscoring the heterogeneity and aggressiveness of CAPS, the importance of systematic exclusion of mimics when histopathology is not feasible, and the value of early "triple therapy" with escalation (e.g., rituximab) in refractory presentations. Large-vessel with cardiac extension (SVC→RA) in CAPS is uncommon and warrants heightened suspicion, even in young patients without conventional risk factors.

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Cite This Study

Skafi et al. (2026) studied this question.

synapsesocial.com/papers/69ddd8eee195c95cdefd66f0https://doi.org/10.1186/s13019-026-04006-y
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