Document Detail


Hemolysis and elevated transaminases imitating severe preeclampsia.
MedLine Citation:
PMID:  19155951     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Illnesses coincident with pregnancy may present similarly to preeclampsia or may be mistaken for severe preeclampsia or hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome. Distinguishing these imitators from preeclampsia is important to allow for appropriate treatment and to avoid unnecessary delivery. CASE: A primigravida at 32 2/7 weeks of gestation transferred to our institution with flu-like symptoms, anemia, jaundice, and elevated liver function tests. The team caring for her was concerned about HELLP or acute fatty liver. After extensive workup, she was found to have a cold agglutinin. Her laboratory test results improved, and she was discharged undelivered with a presumptive diagnosis of cold agglutinin autoimmune hemolytic anemia. CONCLUSION: When patients present with atypical features of HELLP syndrome, clinicians should take time to consider other "imitators of preeclampsia" before rapidly progressing to delivery to avoid inappropriate treatment of the disorder.
Authors:
Bridget Kamen; Mark A Karwal; Jerome Yankowitz
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  113     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-01-21     Completed Date:  2009-02-23     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  545-7     Citation Subset:  AIM; IM    
Affiliation:
Departments of Internal Medicine, University of Iowa College of Medicine Iowa City, Iowa, USA. bridget-kamen@uiowa.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Alanine Transaminase / blood
Anemia, Hemolytic, Autoimmune / diagnosis*,  enzymology
Aspartate Aminotransferases / blood
Diagnosis, Differential
Female
HELLP Syndrome / diagnosis*
Humans
Liver Function Tests
Pregnancy
Chemical
Reg. No./Substance:
EC 2.6.1.1/Aspartate Aminotransferases; EC 2.6.1.2/Alanine Transaminase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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