Microangiopathic Hemolytic Anemia Due to Malignancy in Pregnancy.

Abstract:

BACKGROUND:Microangiopathic disorders during pregnancy remain a diagnostic challenge because these conditions often imitate more common obstetric diseases. CASE:A 31-year-old multigravid woman delivered at term with a postpartum course complicated by laboratory indices consistent with hemolysis, elevated liver enzymes, and low platelet count syndrome. After clinical recovery, she was readmitted 2 weeks after delivery with presumptive pyelonephritis. Persistent hemolysis and worsening thrombocytopenia suggested a diagnosis of thrombotic microangiopathy, which did not respond to plasma exchange. Directed bone biopsy revealed metastatic signet ring cell adenocarcinoma. CONCLUSION:Microangiopathic hemolytic anemia is rarely the initial clinical manifestation of malignancy. Given the similar features of several common obstetric complications, additional diagnostic measures may be necessary to refine the diagnosis in cases unresponsive to standard obstetric management.

journal_name

Obstet Gynecol

authors

Happe SK,Zofkie AC,Nelson DB

doi

10.1097/AOG.0000000000001675

subject

Has Abstract

pub_date

2016-12-01 00:00:00

pages

1437-1440

issue

6

eissn

0029-7844

issn

1873-233X

pii

00006250-201612000-00031

journal_volume

128

pub_type

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