We describe a 60-year-old man with nephrotic syndrome due to a glomerular t
hrombotic microangiopathy caused by the antiphospholipid syndrome (APS) ass
ociated with a lung adenocarcinoma. Although no significant aggravation of
APS was noted following renal biopsy, catastrophic exacerbation of APS occu
rred 3 days after a lung adenocarcinoma biopsy while warfarin and prednisol
one were being administered. The patient died of multiple organ failure 37
days after the lung adenocarcinoma biopsy. This case emphasizes the need fo
r great caution for catastrophic exacerbation of malignancy associated APS
following biopsy of the underlying malignancy.