title: Cytomegalovirus may mimic the presentation of intrahepatic cholestasis and hemolysis, elevated liver enzymes and low platelets in immunosuppressed pregnant women.
abstract: Most published cases of cytomegalovirus infection in pregnancy relate to congenital abnormalities in neonates infected in early pregnancy, while the mother remains asymptomatic. We describe a diagnostically challenging case of an immunosuppressed woman with scleroderma who developed deranged liver function tests attributed to intrahepatic cholestasis of pregnancy and haemolysis, elevated liver enzymes and low platelets syndrome but was ultimately found to have disseminated cytomegalovirus. Cytomegalovirus can present in a myriad of ways. Clinicians caring for immunocompromised pregnant women should consider cytomegalovirus as a possible differential diagnosis when reviewing abnormal liver function tests.
authors.affiliation: De Swiet Obstetric Medicine Centre, Queen Charlotte's & Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK.
authors.forename: Gurleen
authors.initials: G
authors.lastname: Wander
authors.affiliation: De Swiet Obstetric Medicine Centre, Queen Charlotte's & Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK.
authors.forename: Francesa
authors.initials: F
authors.lastname: Neuberger
authors.affiliation: De Swiet Obstetric Medicine Centre, Queen Charlotte's & Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK.
authors.forename: Mandish K
authors.initials: MK
authors.lastname: Dhanjal
authors.affiliation: De Swiet Obstetric Medicine Centre, Queen Charlotte's & Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Nelson-Piercy
authors.affiliation: De Swiet Obstetric Medicine Centre, Queen Charlotte's & Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK; Silver Star Unit, Women's Centre, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, Oxfordshire, UK.
authors.forename: May Ching
authors.initials: MC
authors.lastname: Soh
keywords: HELLP syndrome; Pregnancy; cytomegalovirus infection; immunocompromised; scleroderma