Contributed by Peter Christakos MD, Ileana Lopez MD, Darell Triulzi MD
Published on line in June 1998
CLINICAL HISTORY:
This 25 year old gravida 2 para 1 white female gave birth at 42 weeks to a baby boy by vaginal delivery. She developed oliguria with 2+ proteinuria on urinalysis four hours following delivery, and subsequently developed pitting edema of the upper and lower extremities, blurred vision, and mild jaundice without hypertension. The patient was transferred to the University of Pittsburgh Medical Center (UPMC) on post-partum day 3 for further medical treatment.
SELECTED LABORATORY DATA
Day of delivery (at Uniontown Hospital):
Hemoglobin (Hgb) | 7.8 g/dL (decreased) |
---|---|
Platelets (plts) | 49,000cu mm (decreased) |
Prothrombin time (PT) | 12.7 sec. (normal) |
Partial thromboplastin time (PTT) | 33 sec. (normal) |
Total bilirubin (t bili) | 1.9 mg/dL (increased) |
Lactate dehydrogenase (LDH) | 41 U/L (normal) |
Aspartate aminotransferase (AST) | 263 U/L (increased) |
Blood Urea Nitrogen (BUN) | 12 mg/dL (normal) |
Serum creatinine (cr) | 2.5 mg/dL (increased) |
Peripheral blood smear | Schistocytes, RBC fragments |
Post partum day 3 (at UPMC) (normal value in parenthesis):
Hgb | 6.8 mg/dL (12-16 g/dL) |
---|---|
Plts | 52,000cu mm (150-450) |
LDH | 1738 U/L (<170) |
AST | 79 U/L (<40) |
T. bili | 0.6 mg/dL (.3-1.5) |
BUN | 61 mg/dL (5-20) |
Serum creatinine | 6.6 mg/dL (.5-1.4) |
PT | 11.9 sec. (11.2-14.4) |
PTT | 22.9 sec. (20-30) |
Haptoglobin | <5.8 mg/dL (31-335) |
Fibrin Degradation Products (FDP) | 2.5 ug/ml (normal <2.5) |
Fibrinogen | 460 mg/ dL (normal 150-450) |
Peripheral blood smear | Schistocytes, helmet cells |