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J Korean Soc Emerg Med > Volume 16(2); 2005 > Article
Journal of The Korean Society of Emergency Medicine 2005;16(2): 317-321.
A Case of HELLP Syndrome with Liver Infarction and Cerebral Venous Thrombosis
Yun Kwon Kim, Kang Hyun Lee, Sung Byum Oh, Kyung Chul Cha, Sun Hyu Kim, Ho Joong Kim, Hyun Kim, Sung Oh Hwang
Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea. ed119@wonju.yonsei.co.kr
We describe a rare case of cerebral venous thrombosis and liver infarction with HELLP syndrome in a 25-year-old woman with eclampsia. She had complained of epigastric pain and had visited a local hospital for treatment. Also, signs of fetal distress were presented. After an emergency cesarean section, generalized tonic-clonic seizure occurred twice at a 10-minute interval. The patients was transferred to our emergency room, and the neurologic examination at that time, revealed a deep drowsy mentality and positive Babinski's sign; the deep tendon reflex was two positive. The laboratory findings revealed thrombocytopenia, an elevated liver function test, abnormal coagulation profiles. A bilateral ischemic change with left basal ganglia hemorrhage was seen on brain CT, and multiple foci of ill defined low-density lesions, mainly in the subcapsular portion of the liver and perivascular space, were visible on the abdominal CT. There was a faint showing of the deep venous system on the angiogram of both carotid arteries and a cerebral venous thrombosis was confirmed by using 4-vessel angiography. During the following 2 days, the cerebral hemorrhage and the low-density lesion were resolved through applications of heparin, and the patient returned to a nearly alert mental status. Finally she died of a hemorrhagic shock as a complication of disseminated intravascular coagulation.
Key words: Hellp syndrome, Liver, Infarction, Cerebral thrombosis
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