Abstract
Catastrophic Antiphospholipid Syndrome (CAPS) is a rare serious form of APS characterized by thrombosis in multiple organs and a cytokine storm. We report a complex case of a 28-year-old female that tested positive for COVID-19 with a medical history of deep vein thrombosis, pulmonary embolus and systemic lupus erythematosus, with underlying APC, complicating her case of CAPS in multiple organs. Computed Tomography (CT) PE reveled extensive pulmonary emboli and an elevated right/left ventricular ratio (RV/LV). CT of the abdomen and pelvis showed gastritis, ascites and anasarca, fluid accumulation and small bilateral pleural effusions. Urinalysis showed low levels of albumin, urine protein 4+ g, and hyperlipidemia. Laboratory test indicated that the patient has developed a worsening non oliguric acute kidney injury and renal biopsy revealed necrotizing. This is a complex case that contributes to the understanding of CAPS and highlights the challenges of its diagnosis and management.