TY - JOUR T1 - Catastrophic Antiphospholipid Antibody Syndrome with Bone Marrow Necrosis: A Rare Complication JF - The Journal of Rheumatology JO - J Rheumatol SP - 2279 LP - 2281 DO - 10.3899/jrheum.110521 VL - 38 IS - 10 AU - YASSER K. KHALIL AU - MICHAEL J. PISTORIA AU - ROBERT E. WRIGHT Y1 - 2011/10/01 UR - http://www.jrheum.org/content/38/10/2279.abstract N2 - To the Editor:Catastrophic antiphospholipid antibody syndrome (CAPS) was initially described in 1992 by Asherson1. The syndrome occurs in a very small proportion of patients with APS and carries significant morbidity and mortality. It is defined as acute multiorgan failure resulting from multiple, rapidly developing vascular occlusions. The main organs involved are the renal, pulmonary, and nervous systems. Other organs, including skin, heart, adrenal glands, and liver can also be affected. Rarely, CAPS is associated with bone marrow involvement and necrosis due to microvascular thrombosis2. This case details that rare relationship and the need for early identification and treatment of CAPS.A 40-year-old Hispanic woman presented to the emergency department with 5 hours of severe lumbosacral pain. The pain developed suddenly and was aggravated by movement. She related that the pain radiated to the left lower extremity. There was no history of trauma and she found that nothing alleviated the pain. Her history was significant for chronic thrombocytopenia, menorrhagia (for which she was taking oral contraceptives), and 2 second-trimester spontaneous abortions. Examination revealed paraspinal tenderness in the lumbosacral region. Plain radiographs of lumbosacral spine demonstrated only a loss of normal lordosis.The white blood cell count was 6200/μl, with 85% neutrophils, 11% lymphocytes, 14% monocytes, and … Address correspondence to Dr. Y.K. Khalil, 1240 South Cedar Crest Blvd., Suite 409, Allentown, PA 18103, USA. E-mail: yasser_k.khalil{at}lvhn.org ER -