Objective: Pulmonary capillaritis is an uncommon complication of antiphospholipid antibody syndrome but has important therapeutic implications.
Case report: A patient with antiphospholipid antibody syndrome presented with haemoptysis and respiratory failure. Investigation including open lung biopsy, demonstrated vasculitis as the underlying pathology, rather than thrombosis. The patient responded promptly to methylprednisolone, cyclophosphamide and plasmapheresis.
Conclusion: Plasmapheresis has not previously been described in this setting and the rapid response suggests that it should be considered in severe disease.