Clotting Conundrum: Unraveling Male Antiphospholipid Syndrome

Abstract

APS (Antiphospholipid syndrome) is categorized by thromboembolic events and pregnancy-related complications, accompanied by persistently higher levels of antiphospholipid antibodies. Clinical presentations of Antiphospholipid syndrome are highly variable, with potential involvement of any organ system, making it relevant across numerous medical and surgical specialties. We present a case of 38-year-old male having no prior co-morbidities reported a history of left lower limb pain as well as breathlessness for 2 days, with no history of immobilisation, recent surgery, smoking, or previous history of deep vein thrombosis. Lower limb Doppler ultrasound showed a thrombus in left popliteal vein. A CT pulmonary angiogram revealed thromboembolism in the right and left main pulmonary embolism. On thrombophilia workup, the patient has been found to be positive for Anti cardiolipin antibody IgM as well as Beta-2 glycoprotein IgG antibody. Patient was started on I.V heparin infusion. No other clinical or laboratory evidence for other systemic or autoimmune illnesses was identified. During the course of hospitalisation, the patient developed abrupt onset of abdominal pain. Contrast-enhanced CT scan of abdomen presented bilateral deep vein thrombosis extending into left renal vein along with inferior vena cava. Despite early initiation of treatment, our patient did not survive. This case report highlights the severe and rapidly progressive nature of antiphospholipid syndrome, underscoring the importance of early diagnosis and aggressive management to improve outcomes.