Case 419 -- A pregnant woman in her early 40s with thrombocytopenia

Contributed by S. Chiosea, MD and F. Bontempo, MD
Published on line in March, 2005


PATIENT HISTORY:

A Caucasian woman in her early 40s without significant past medical and family history was found to be thrombocytopenic during the third trimester of her pregnancy. Her platelet count was 24x109/L. She received platelets transfusion and underwent an emergent Cesarean section delivery without complication. Her postpartum course was complicated by a mild hemolytic anemia and she underwent plasmapheresis with no response. She was tapered off of steroids and maintained a platelet count of 45x10^9/L. One year later the patient presented with acute dull pain in right upper abdominal quadrant and enlarged liver. Her LDH was 694 IU/L (<170) and a CT scan of the abdomen revealed hepatosplenomegaly with hepatic (Budd-Chiari syndrome) and splenic veins thromboses.

PREVIOUS MEDICAL HISTORY:

ALLERGY:

LAB RESULTS:

FINAL DIAGNOSIS


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