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Catastrophic Antiphospholipid Syndrome in Combination with SLE Treated by Rituximab: A Case Report and Literature Review

El nour Mohammed El agib, Noha Ibrahim Ahmed Eltahir, Mohammed Elmujtba Adam Essa Adam, Ziryab Imad Taha Mahmoud, Habiballa Hago Mohamed Yousif, Azza A.Abdelsatir, Mutwaly Defealla Yousif Haron

Antiphospholipid Syndrome (APS) is a multisystem autoimmune disorder characterized by increased risk of small vessel and venous thrombosis and/or pregnancy complications (fetal death in utero, miscarriage), with persistently elevated plasma level of antiphospholipid antibodies. Given the high mortality rate, the term (catastrophic) has been used to describe this life threating condition which is rare and represents about 1% of all APS patients, where development of fatal complication characterize the occurrence of multi organs thrombosis over a short period of time. Our case is 33 years old female patient, grand multipara, diagnosed as a case of CAPS with SLE according to the preliminary criteria for the classification of CAPS. Fulfillment of 3 out of 4 criteria is required for diagnosis of CAPS. The patient was treated with prednisolone, amlodipine, calcium carbonate, hemodialysis, intravenous immunoglobulin (IVIG) which was stopped due to development of allergic reaction. One month later, Rituximab was introduced, then her general condition improved, symptom subsided and hemodialysis was stopped with recovery of renal function. It's important to guide more efforts and studies to emphasize the role of rituximab in CAPS because it may be an effective therapeutic option for treating CAPS patients.