A Case of HELLP Syndrome with Liver Infarction and Cerebral Venous Thrombosis.
- Author:
Yun Kwon KIM
1
;
Kang Hyun LEE
;
Sung Byum OH
;
Kyung Chul CHA
;
Sun Hyu KIM
;
Ho Joong KIM
;
Hyun KIM
;
Sung Oh HWANG
Author Information
1. Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea. ed119@wonju.yonsei.co.kr
- Publication Type:Case Report
- Keywords:
Hellp syndrome;
Liver;
Infarction;
Cerebral thrombosis
- MeSH:
Adult;
Angiography;
Basal Ganglia Hemorrhage;
Brain;
Carotid Arteries;
Cerebral Hemorrhage;
Cesarean Section;
Disseminated Intravascular Coagulation;
Eclampsia;
Emergencies;
Emergency Service, Hospital;
Female;
Fetal Distress;
HELLP Syndrome*;
Heparin;
Humans;
Infarction*;
Intracranial Thrombosis;
Liver Function Tests;
Liver*;
Neurologic Examination;
Pregnancy;
Reflex, Babinski;
Reflex, Stretch;
Seizures;
Shock, Hemorrhagic;
Thrombocytopenia;
Tomography, X-Ray Computed;
Venous Thrombosis*
- From:Journal of the Korean Society of Emergency Medicine
2005;16(2):317-321
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
We describe a rare case of cerebral venous thrombosis and liver infarction with HELLP syndrome in a 25-year-old woman with eclampsia. She had complained of epigastric pain and had visited a local hospital for treatment. Also, signs of fetal distress were presented. After an emergency cesarean section, generalized tonic-clonic seizure occurred twice at a 10-minute interval. The patients was transferred to our emergency room, and the neurologic examination at that time, revealed a deep drowsy mentality and positive Babinski's sign; the deep tendon reflex was two positive. The laboratory findings revealed thrombocytopenia, an elevated liver function test, abnormal coagulation profiles. A bilateral ischemic change with left basal ganglia hemorrhage was seen on brain CT, and multiple foci of ill defined low-density lesions, mainly in the subcapsular portion of the liver and perivascular space, were visible on the abdominal CT. There was a faint showing of the deep venous system on the angiogram of both carotid arteries and a cerebral venous thrombosis was confirmed by using 4-vessel angiography. During the following 2 days, the cerebral hemorrhage and the low-density lesion were resolved through applications of heparin, and the patient returned to a nearly alert mental status. Finally she died of a hemorrhagic shock as a complication of disseminated intravascular coagulation.
