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A 31-year-old male patient with unremarkable medical history presented with a sudden onset of left-sided body weakness including upper and lower extremities, frontal headache, and slurred speech. Diagnostic workup revealed diffuse ST elevation with elevated cardiac enzymes, elevated inflammatory markers, prolonged activated partial thromboplastin time (aPTT), hemolytic anemia, and intrarenal kidney injury. Further investigations confirmed the diagnosis of probable CAPS secondary to SLE, based on the simultaneous involvement of the brain, heart, and kidneys, along with the presence of positive antiphospholipid antibodies (aPL). The patient showed significant improvement in neurological functioning after treatment with Methylprednisolone, Hydroxychloroquine, Colchicine, and Rituximab.<\/jats:p>","DOI":"10.1093\/omcr\/omae208","type":"journal-article","created":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:25:56Z","timestamp":1742516756000},"source":"Crossref","is-referenced-by-count":2,"title":["Catastrophic antiphospholipid syndrome presenting with a stroke as a first presentation: case report"],"prefix":"10.1093","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6397-8033","authenticated-orcid":false,"given":"Ahmad","family":"Nouri","sequence":"first","affiliation":[{"name":"Department of Medicine, Faculty of Medicine & Health Sciences, An-Najah National University , Nablus ,","place":["Palestine"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5122-8200","authenticated-orcid":false,"given":"Ameer","family":"Awashra","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine & Health Sciences, An-Najah National University , Nablus ,","place":["Palestine"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5577-8499","authenticated-orcid":false,"given":"Mohammad","family":"Alnees","sequence":"additional","affiliation":[{"name":"Harvard Medical School Postgraduate Medical Education, Global Clinical Scholars Research Training program , Boston ,","place":["United States"]},{"name":"Head of Palestinian Clinical Research Center , Bethlehem ,","place":["Palestine"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3065-5396","authenticated-orcid":false,"given":"Hadi","family":"Rabee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, An-Najah National University Hospital , Nablus ,","place":["Palestine"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alaa","family":"Shamlawi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, An-Najah National University Hospital , Nablus ,","place":["Palestine"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,3,20]]},"reference":[{"key":"2025032016293059000_ref1","doi-asserted-by":"publisher","first-page":"e30330","DOI":"10.7759\/cureus.30330","article-title":"An overview of systemic lupus erythematosus (SLE) pathogenesis, classification, and management","volume":"14","author":"Ameer","year":"2022","journal-title":"Cureus"},{"volume-title":"StatPearls","year":"2023","author":"Bustamante","key":"2025032016293059000_ref2"},{"key":"2025032016293059000_ref3","doi-asserted-by":"publisher","first-page":"9","DOI":"10.12860\/jnp.2014.03","article-title":"Catastrophic antiphospholipid syndrome: a clinical review","volume":"3","author":"Nayer","year":"2014","journal-title":"J Nephropathol"},{"key":"2025032016293059000_ref4","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1080\/17474086.2017.1300522","article-title":"Diagnosis and management of catastrophic antiphospholipid syndrome. 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