ACLY and autoimmune polyendocrinopathy: So, the patient was referred to a rheumatologist who diagnosed her with primary APS based on the arterial thrombotic events i.e. myocardial infarctions, retinal microvascular thrombosis i.e. Purtscher-like retinopathy, thrombosed segments of radial, ulnar, anterior tibial, posterior tibial and peroneal arteries in arterial duplex and CT angiography (Fig. 5) and positive anticardiolipin antibodies (aCL) according to the updated Sapporo classification of APS [23].