Atypical Presentation of Catastrophic Antiphospholipid Syndrome (CAPS) Following Cesarean Delivery in a Patient With Persistent Multiorgan Dysfunction: A Case Report.

Catastrophic antiphospholipid syndrome (CAPS) is a rare, life-threatening condition with 30% mortality that poses diagnostic challenges during pregnancy due to overlap with preeclampsia and HELLP syndrome. We report a woman in her 30s who developed probable CAPS following emergency cesarean delivery at 22 weeks for severe preeclampsia. Unlike typical CAPS presentations, our patient lacked characteristic cutaneous manifestations, instead presenting with progressive cardiac, pulmonary, and renal dysfunction persisting despite delivery. Serial chest radiographs showed significant pulmonary edema and worsening bilateral pleural effusions, requiring noninvasive positive pressure ventilation and chest tube placement. The patient improved with supportive care and was discharged from ICU after 7 days. This case emphasizes the importance of considering CAPS in patients with persistent multiorgan dysfunction following delivery, even without typical cutaneous findings. Recognition of atypical presentations may facilitate timely intervention and improve patient outcomes.