Expert Perspective: Management of Microvascular and Catastrophic Antiphospholipid Syndrome.

A 50-year-old male with antiphospholipid syndrome (APS) presents to your office for the first time with a three-month history of worsening dyspnea, dry cough, and early morning blood-tinged sputum. His APS diagnosis was based on an unprovoked left lower extremity deep vein thrombosis, four years prior to the presentation, with persistent (multiple occasions) triple antiphospholipid antibody (aPL)-positivity, defined as lupus anticoagulant (LA) test positive performed while off anticoagulation, high titer [≥80 U] IgG anticardiolipin antibodies (aCL), and high titer IgG anti-β2 -glycoprotein-I (aβ2 GPI). He has no other past medical history; and he is on warfarin with a target international normalized ratio (INR) of 2.5 to 3.