We describe the case of a 53-year-old man who presented with a cerebellar stroke. He developed a thrombus in his left ileo-femoral vein, and his IgG anticardiolipin antibody turned out to be positive. He then developed thrombosis of the right ileo-femoral vein while well anticoagulated with warfarin. Despite aggressive anticoagulation he developed livedo reticularis, pulmonary embolism, adult respiratory distress syndrome and renal failure over a few weeks and eventually died from a large gastrointestinal bleeding. He probably had catastrophic antiphospholipid syndrome (CAPS) or Asherson’s syndrome, which has a high mortality. We discuss the current treatment options available for such a patient.
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