Pathological Study of a Case of Catastrophic Antiphospholipid Syndrome in a Patient With Gastrointestinal Bleeding
Bibliographic record
Abstract
Catastrophic antiphospholipid syndrome (CAPS) is a very rare, life-threatening form of antiphospholipid syndrome (APS) characterized by multiorgan vascular occlusive events that occur rapidly in succession or simultaneously. Here, we describe a rare case of CAPS in a 67-year-old woman with a 26-year history of APS managed on therapeutic doses of warfarin presenting to hospital with a four-day history of melena secondary to gastrointestinal bleed. She was treated endoscopically, provided vitamin K for warfarin reversal, and started on dalteparin daily. During her course in hospital, she developed dyspnea and hypoxia with bilateral pleural effusions. The patient concurrently became increasingly hemodynamically unstable. She was treated with furosemide and broad-spectrum antibiotics but deteriorated, experienced cardiac arrest, and could not be successfully resuscitated. On autopsy, widespread microthrombi in cardiac, pulmonary, and cerebral tissues were identified and a diagnosis of CAPS was made. This case highlights the difficulty and importance of recognizing clinical manifestations of CAPS and balancing the risk for thrombosis when patients are undergoing treatment for concurrent serious health issues.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".