First presentation of Graves' thyroid storm complicated by catastrophic antiphospholipid antibody syndrome: A case report

SAGE Open Med Case Rep. 2024 May 11:12:2050313X241252809. doi: 10.1177/2050313X241252809. eCollection 2024.


Catastrophic antiphospholipid antibody syndrome is a rare and severe subtype of antiphospholipid syndrome with multisystemic organ failure due to thromboembolic events, resulting in high mortality rates. The association between catastrophic antiphospholipid antibody syndrome and autoimmune thyroid diseases is rarely reported in the literature. We report a case of a 35-year-old previously healthy female with Graves' thyroid storm, positive lupus antibodies, and probable catastrophic antiphospholipid antibody syndrome. Her hospital course was complicated by extensive venous thromboembolism, superior vena cava syndrome, thromboembolic strokes, and Takotsubo cardiomyopathy. Eventually, this led to an unfortunate death secondary to profound shock after 8 days despite emergent treatment. Our case report discusses the link between autoimmune thyroid disorders and catastrophic antiphospholipid antibody syndrome. We emphasize the difficulty in diagnosing catastrophic antiphospholipid antibody syndrome in extremely ill patients and stress the significance of considering it as a possible cause in thyrotoxicosis patients with multiple organ failure and hypercoagulability. Early recognition and prompt management are crucial in improving outcomes in these patients.

Keywords: SLE; antiphospholipid syndrome; catastrophic antiphospholipid syndrome; graves’ disease; superior vena cava syndrome; systemic lupus erythematosus; thyroid storm; thyrotoxicosis.

Publication types

  • Case Reports