Permanent visual deficits secondary to the HELLP syndrome.
A 34-year-old woman with eclampsia and the hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome developed encephalopathy, cardiomyopathy, pulmonary edema, liver failure, and disseminated intravascular coagulation (DIC), all of which resolved. She also had retinal hemorrhages in both eyes and a hemorrhagic infarct in the left occipital lobe that resulted in a permanent right homonymous hemianopia and a persistently depressed acuity of 20/100 OS. This case is unusual in demonstrating permanent visual deficits. In nearly all cases of preeclampsia or eclampsia, visual deficits are reversible. The superimposition of the HELLP syndrome may create more neurologic damage. Clinicians should be alert to patients at risk for HELLP syndrome and manage them aggressively.
Murphy
Marjorie A
MA
Department of Ophthalmology, Rhode Island Hospital, Brown Medical School, APC 7, 593 Eddy Street, Providence, RI 02903, USA. margie.murphy@cox.net
Ayazifar
Mitra
M
D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D020520:Brain Infarction / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D004359:Drug Therapy, Combination; D004461:Eclampsia / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D005665:Furosemide / Q000627:therapeutic use; D017359:HELLP Syndrome / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006423:Hemianopsia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D020300:Intracranial Hemorrhages / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D007741:Labetalol / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008353:Mannitol / Q000008:administration & dosage; D009543:Nifedipine / Q000627:therapeutic use; D009778:Occipital Lobe / Q000098:blood supply* / Q000473:pathology; D011247:Pregnancy; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D014792:Visual Acuity
D008353:Mannitol; D005665:Furosemide; D009543:Nifedipine; D007741:Labetalol