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A Rare Case of HELLP Syndrome with Hematomas of Spleen and Liver, Eclampsia, Severe Hypertension and Prolonged Coagulopathy—A Case Report

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  • Małgorzata Lewandowska

    (Department of Biochemistry and Molecular Biology, Poznan University of Medical Sciences, 60-781 Poznan, Poland
    Division of Gynecological Surgery, University Hospital, 33 Polna Str., 60-535 Poznan, Poland)

  • Monika Englert-Golon

    (Department of Gynaecology Obstetrics and Gynaecological Oncology, Division of Gynecological Surgery, Poznan University of Medical Sciences, 60-535 Poznan, Poland)

  • Zbigniew Krasiński

    (Department of Vascular, Endovascular Surgery, Angiology and Phlebology, Poznan University of Medical Sciences, 61-848 Poznan, Poland)

  • Paweł Piotr Jagodziński

    (Department of Biochemistry and Molecular Biology, Poznan University of Medical Sciences, 60-781 Poznan, Poland)

  • Stefan Sajdak

    (Department of Gynaecology Obstetrics and Gynaecological Oncology, Division of Gynecological Surgery, Poznan University of Medical Sciences, 60-535 Poznan, Poland)

Abstract

The HELLP syndrome (hemolysis, liver damage and thrombocytopenia) is a rare (0.5–0.9%) but serious complication of pregnancy or puerperium associated with a higher risk of maternal and fetal mortality and morbidity. Liver and spleen hematomas rarely entangle (<2%) HELLP cases, but rupture of the hematomas presents an immediate threat to life. We present the history of a 35-year old pregnant woman (at the 31st week) admitted to our hospital due to the risk of premature delivery. On the first day, the patient did not report any complains, and the only abnormality was thrombocytopenia 106 G/L. However, within several hours, tests showed platelet levels of 40.0 G/L, LDH 2862.0 U/L and AST 2051.6 U/L, and the woman was diagnosed with severe HELLP syndrome, complicated by hematomas of the liver and spleen, seizures (eclampsia), severe arterial hypertension and coagulation disorders. The purpose of this article is to highlight the need for early investigation of the causes of thrombocytopenia and the differentiation of HELLP from other thrombotic microangiopathies (TMAs).

Suggested Citation

  • Małgorzata Lewandowska & Monika Englert-Golon & Zbigniew Krasiński & Paweł Piotr Jagodziński & Stefan Sajdak, 2022. "A Rare Case of HELLP Syndrome with Hematomas of Spleen and Liver, Eclampsia, Severe Hypertension and Prolonged Coagulopathy—A Case Report," IJERPH, MDPI, vol. 19(13), pages 1-10, June.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:13:p:7681-:d:846004
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    References listed on IDEAS

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    1. Małgorzata Lewandowska, 2021. "The Association of Familial Hypertension and Risk of Gestational Hypertension and Preeclampsia," IJERPH, MDPI, vol. 18(13), pages 1-15, July.
    2. Kestutis Rimaitis & Lina Grauslyte & Asta Zavackiene & Vilda Baliuliene & Ruta Nadisauskiene & Andrius Macas, 2019. "Diagnosis of HELLP Syndrome: A 10-Year Survey in a Perinatology Centre," IJERPH, MDPI, vol. 16(1), pages 1-9, January.
    3. Irene Aracil Moreno & Patrocinio Rodríguez-Benitez & Maria Ruiz-Minaya & Mireia Bernal Claverol & Virginia Ortega Abad & Concepción Hernández Martin & Pilar Pintado Recarte & Fátima Yllana & Cristina , 2021. "Maternal Perinatal Characteristics in Patients with Severe Preeclampsia: A Case-Control Nested Cohort Study," IJERPH, MDPI, vol. 18(22), pages 1-12, November.
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