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[Normotensive HELLP syndrome: report of one case]
Revista Medica De Chile
|April 11, 2014
Summary
HELLP syndrome, a severe preeclampsia complication, can present atypically. This case highlights a pregnant patient with HELLP syndrome and normal blood pressure, leading to fetal death.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Critical Care Medicine
Background:
- HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) is a severe variant of preeclampsia.
- It is associated with significant maternal and fetal complications, including mortality.
- HELLP syndrome typically manifests during severe preeclampsia but can present atypically.
Observation:
- A 22-year-old pregnant patient presented at 20 weeks with lumbar pain, dysuria, and fever.
- Initial urinalysis showed white blood cells, treated with antimicrobials.
- Proteinuria (440 mg/24 h) was detected 48 hours post-admission, alongside elevated liver enzymes and creatinine, despite normal blood pressure.
Findings:
- A diagnosis of severe preeclampsia-HELLP syndrome was made.
- The patient experienced fetal demise five days after admission.
- Fetal abortion was induced, and the patient required a platelet transfusion.
Implications:
- This case underscores the importance of recognizing atypical presentations of HELLP syndrome, even with normal blood pressure.
- Prompt diagnosis and management are crucial in severe preeclampsia-HELLP syndrome to mitigate maternal and fetal risks.
- Further research into early diagnostic markers for atypical HELLP syndrome presentations is warranted.
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