Wednesday, August 27, 2008


A pregnant woman at 32 weeks gestation presents with abdominal pain, nausea, vomiting, and malaise. She has mid-epigastric and right upper quadrant tenderness. Exam shows blood pressure 150/90 and proteinuria. Labs show platelets at 80,000, serum LDH 800, total bilirubin 2.0, and serum AST 120.

Challenge: What is your diagnosis?

Image shown under fair use.


Alex said...

HELLP syndrome?

Craig said...


As the title suggests, this is HELLP syndrome characterized by a microangiopathic hemolytic anemia (seen in the peripheral blood smear), elevated liver enzymes, and a low platelet count. The cornerstone of therapy is delivery.

Sources: UpToDate, image originally courtesy of Carola von Kapff.