{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:13:12Z","timestamp":1777929192241,"version":"3.51.4"},"reference-count":38,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Catastrophic Antiphospholipid Syndrome (CAPS) is a rare but highly severe manifestation of antiphospholipid syndrome (APS), occurring in fewer than 1% of APS patients, but is associated with mortality of around 25\u201337%, despite treatment. It is characterized by rapid onset of widespread thrombotic events leading to microangiopathy, intravascular thrombosis with multiorgan failure, involving three or more organs within one week. Most published data originate from European or multinational registries like the CAPS Registry. However, data on CAPS in Latin American populations, who may differ in genetic background, socioeconomic status, and healthcare access, remain scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The objective was to describe the clinical characteristics, treatment strategies, and outcomes of patients diagnosed with CAPS at a tertiary referral center in Mexico City over 5\u00a0years. We conducted a retrospective cohort study of patients who fulfilled the CAPS classification criteria between January 2019 and December 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nineteen patients were included (74% female; median age 38.4 years). Six had primary APS, while 11 had concomitant systemic lupus erythematosus (SLE). Based on the 2019 EULAR aPL titers classification, seven patients were classified as low-risk and 12 as high-risk. In 47%, CAPS was the first manifestation of APS. Precipitating factors were identified in 94.7% of cases, most commonly infections and anticoagulant withdrawal. The most frequently affected were the arterial and venous circulation (74% and 68%, respectively), hematologic manifestations (47%), kidneys (42%), lungs (42%), and the heart (32%). Treatment strategies included anticoagulation (84%), corticosteroids (79%), plasma exchange (79%), triple therapy (74%), and, in selected cases, immunosuppressants. Overall mortality was 42%; among survivors, 75% achieved full recovery with no relapses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study represents one of the largest single-center series of CAPS in a non-Caucasian population. Our findings reveal a predominance of high-risk, secondary APS\u2014mainly SLE-associated\u2014with thrombocytopenia. Nearly half presented with CAPS as the initial APS manifestation. Limited access to full triple therapy significantly impacted mortality, which decreased from 100% with partial therapy to 21% with complete regimens. Early recognition, prompt management, and multidisciplinary care were associated with favourable outcomes, underscoring the need for adaptable therapeutic strategies in resource-limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09612033261422651","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T06:29:42Z","timestamp":1769668182000},"page":"387-398","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Catastrophic antiphospholipid syndrome: Clinical characteristics and outcomes in a non-caucasian population \u2014 A five-year experience from a single centre"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5955-4601","authenticated-orcid":false,"given":"Rodolfo","family":"Jim\u00e9nez-Soto","sequence":"first","affiliation":[{"name":"National Institute of Medical Sciences and Nutrition \u201cSalvador Zubir\u00e1n\u201d"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Espinosa-Le\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Instituto Tecnol\u00f3gico y de Estudios Superiores de Monterrey (ITESM)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9037-1339","authenticated-orcid":false,"given":"Jos\u00e9 Emilio","family":"Said-Diego","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Instituto Tecnol\u00f3gico y de Estudios Superiores de Monterrey (ITESM)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1575-0747","authenticated-orcid":false,"given":"Mariel","family":"Mart\u00ednez-Ru\u00edz","sequence":"additional","affiliation":[{"name":"National Institute of Medical Sciences and Nutrition \u201cSalvador Zubir\u00e1n\u201d"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iris Paola","family":"Garc\u00eda-Herrera","sequence":"additional","affiliation":[{"name":"National Institute of Medical Sciences and Nutrition \u201cSalvador Zubir\u00e1n\u201d"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda del Carmen","family":"Zamora-Medina","sequence":"additional","affiliation":[{"name":"National Institute of Perinatology \u201cIsidro Espinosa de Los Reyes\u201d"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5870-0523","authenticated-orcid":false,"given":"Javier","family":"Merayo-Chalico","sequence":"additional","affiliation":[{"name":"National Institute of Medical Sciences and Nutrition \u201cSalvador Zubir\u00e1n\u201d"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1336-0163","authenticated-orcid":false,"given":"Gerard","family":"Espinosa","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednic de Barcelona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8060-7301","authenticated-orcid":false,"given":"Guillermo Arturo","family":"Guaracha-Basa\u00f1ez","sequence":"additional","affiliation":[{"name":"National Institute of Medical Sciences and Nutrition \u201cSalvador Zubir\u00e1n\u201d"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000932"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kead618"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kead632"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtha.2024.03.027"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.42624"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kead571"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.medcli.2024.02.011"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kead603"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1759857"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1191\/0961203303lu394oa"},{"key":"e_1_3_5_12_2","first-page":"4161439","article-title":"Catastrophic antiphospholipid syndrome","volume":"2016","author":"El-Shereef RR","year":"2016","unstructured":"El-Shereef RR, El-Abedin Z, Abdel Aziz R, et al. 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