A case of liver infarction complicating the HELLP syndrome

Tomeno Wataru, Kawamura Nobuyoshi, Fujita Koji, Imajo Kento, Mawatari Hironori, Yoneda Masato, Fujikawa Hirotoshi, Nakajima Atsushi, Saito Satoru

doi:10.2957/kanzo.57.334

<p>A 35-year-old woman with pregnancy-induced hypertension was diagnosed as having the HELLP syndrome one day after completion of 28 weeks of gestation. Because of continuous worsening of the laboratory findings (peak AST 6007 IU/l, ALT 6565 IU/l, LDH 12780 IU/l, and nadir platelet count 3.2 × 10⁴/μl) even after the emergent cesarean section, the obstetricians consulted to our department a day after the cesarean section. Abdominal contrast-enhanced CT revealed massive hepatic infarction in the right lobe, and three consecutive plasma exchanges were performed from the 4th to 6th postpartum day. As a result of the intensive treatment, she gradually recovered from the critical condition, including not only hepatic infarction, but also renal failure, respiratory failure, and disseminated intravascular coagulation. All hepatologists should bear in mind that, in pregnant women with the HELLP syndrome, continuous worsening of the liver enzymes even after delivery could suggest severe liver comorbidities such as liver infarction.</p>

A case of liver infarction complicating the HELLP syndrome

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