IBCC Episode 91 - Catastrophic Antiphospholipid Syndrome

In this episode of The Internet Book of Critical Care Podcast, Josh and Adam Thomas discuss Catastrophic Antiphospholipid Antibody Syndrome (CAPS), a rare and confusing hematologic entity. They delve into the pathophysiology, triggers, and diagnostic challenges of CAPS, emphasizing the importance of considering it in patients with multi-organ failure, especially those with known antiphospholipid antibody syndrome or lupus. The hosts explore the clinical presentation, precipitating factors, and lab tests, including the difficulties in differentiating CAPS from DIC. They also discuss treatment options such as heparin, steroids, plasmapheresis, IVIG, and Eculizumab, highlighting the lack of randomized control trials and the reliance on expert opinion. The discussion concludes with clinical pearls to aid in the diagnosis of CAPS, focusing on recognizing clues like pregnancy, bizarre skin manifestations, and microangiopathic hemolytic anemia.