Partial HELLP syndrome in pregnancy complicated by recurrent deep vein thromboses and palmar skin lesions in a patient with prothrombin gene 20210a mutation and antiphospholipid antibodies: an unusual case.
A patient who developed thrombocytopenia and hypertension accompanied by high levels of antiphospholipid antibodies and abnormal liver function tests in the absence of a hemolytic anemia necessitating termination of pregnancy developed bilateral lower limb thromboses accompanied by painful maculo papular lesions on the palms of both hands a few days after ending the pregnancy. She was then also found to have a prothrombin gene G20210A mutation. She was treated with anticoagulation therapy, but her postpartum course was further complicated by pulmonary embolus. A Greenfield filter was inserted into the inferior vena cava. On low molecular weight heparin, her next pregnancy was uneventful and without any complications.
Asherson
Ronald A
RA
Division of Immunology, School of Pathology, University of the Witwatersrand School of Medicine, Johannesburg, South Africa.
Spargo
Cathy
C
Gómez-Puerta
Jose A
JA
D000032:Abortion, Therapeutic; D000328:Adult; D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants / Q000627:therapeutic use; D005260:Female; D017359:HELLP Syndrome; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D009154:Mutation; D011247:Pregnancy; D011516:Prothrombin / Q000235:genetics*; D011655:Pulmonary Embolism / Q000188:drug therapy / Q000209:etiology*; D020246:Venous Thrombosis / Q000188:drug therapy
D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D011516:Prothrombin