Postpartum catastrophic anti-phospholipid syndrome

Abstract

Multi-organ dysfunction during peripartum period in the background of anti-phospholipid syndrome (APS) poses a tremendous diagnostic dilemma leading to extremely high morbidity and mortality. We present a diagnosed APS case of 29 year old multigravida, who was admitted to intensive care unit with post-partum pulmonary edema, severe thrombocytopenia, paralytic ileus, hepatic and splenic infarcts, status epilepticus and lower limb venous thrombosis despite being on prophylactic anticoagulation. She recovered after treatment with escalating doses of prednisolone, antiepileptics, mechanical ventilator support with muscle paralysis and therapeutic plasma exchange (TPE).This case highlights the utmost importance of awareness, high degree of suspicion and prompt adoption of appropriate supportive treatment to achieve a favourable outcome in catastrophic anti phospholipid syndrome (CAPS).