DIFFUSE SYSTEMIC ARTERIAL CALCIFICATION AND RENAL INFARCTION IN A YOUNG FEMALE WITH PRIMARY ANTIPHOSPHOLIPID SYNDROME PRESENTING AS ACCELERATED HYPERTENSION: A CASE REPORT

Antiphospholipid syndrome (APS) is a prothrombotic autoimmune disorder that can involve both arterial and venous systems, with renal manifestations commonly resulting from vascular injury. Diffuse premature systemic arterial calcification in young patients, however, is an unusual and underrecognized presentation. We report the case of a 28-year-old female who presented with accelerated hypertension. Imaging with CT aortic angiography revealed multifocal renal infarctions along with extensive calcification involving multiple medium-sized arteries, including renal, coronary, internal mammary, intercostal, and iliac vessels. Renal function was preserved. Laboratory evaluation demonstrated elevated anti-B2 glycoprotein I IgG antibodies, with persistent positivity on repeat testing after 12 weeks, while other autoimmune markers were negative.Based on the presence of arterial thrombosis and persistent antiphospholipid antibody positivity, a diagnosis of primary antiphospholipid syndrome was established. The diffuse arterial calcification was considered secondary to chronic thrombotic vasculopathy. This case highlights an unusual imaging presentation of antiphospholipid syndrome and emphasizes the importance of considering a prothrombotic etiology in young patients presenting with unexplained systemic arterial calcification and renal infarction.