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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 |
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| ABSTRACT |
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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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