Obstet Gynecol Sci.  2016 Sep;59(5):397-402. 10.5468/ogs.2016.59.5.397.

Hepatic infarction in a pregnant woman with antiphospholipid syndrome and triple antibody positivity: A case report focusing on catastrophic antiphospholipid syndrome

Affiliations
  • 1Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ohsymd@skku.edu

Abstract

Pregnant women with antiphospholipid syndrome (APS) carry a high risk of arterial or venous thrombosis. Such thrombotic conditions occur more frequently in patients with triple positivity to antiphospholipid antibodies or with high antibody titers. Hepatic infarction is a rare complication in pregnant women with APS, and it sometimes mimics HELLP syndrome. This report describes a preeclamptic pregnant woman with APS who had high titers of three antiphospholipid antibodies. She experienced severe epigastric pain with elevated liver enzymes; in addition, she had tachycardia and tachypnea. The clinical findings suggested hepatic infarction and pulmonary thromboembolism, a partial manifestation of catastrophic APS. Therefore, she underwent emergent cesarean section at 25+2 weeks of gestation. After the delivery, her laboratory test indicated HELLP-like features, and computed tomography confirmed hepatic infarction and pulmonary micro-thromboembolism. Here, we report a case of a partial manifestation of catastrophic APS in a pregnant woman with triple antibody positivity, including a brief literature review.

Keyword

Antiphospholipid antibodies; Catastrophic antiphospholipid syndrome; HELLP syndrome; Hepatic infarction; Triple antibody positivity

MeSH Terms

Antibodies, Antiphospholipid
Antiphospholipid Syndrome*
Cesarean Section
Female
HELLP Syndrome
Humans
Infarction*
Liver
Pregnancy
Pregnant Women*
Pulmonary Embolism
Tachycardia
Tachypnea
Venous Thrombosis
Antibodies, Antiphospholipid
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