BMJ  2007;334:1372 (30 June), doi:10.1136/bmj.39212.564745.BE

Practice

Interactive case report

A patient with suspected miscarriage is found to have hypertension, renal failure, and thrombocytopenia: case presentation

¹ Critical Care and Internal Medicine, Department of Medicine, University College London Hospital, London NW1 2BU, ² Department of Medicine, Hammersmith Hospital, London W12 0HS, ³ West London Renal and Transplant Centre, Hammersmith Hospital, ⁴ Department of Radiology, Hammersmith Hospital, ⁵ Division of Investigative Science, Imperial College London, Hammersmith Hospital Campus, London W12 0NN, ⁶ Division of Medicine, Imperial College London, Hammersmith Hospital Campus

The first 150 words of the full text of this article appear below.

A 46 year old white woman presented to her local casualty department. She had been experiencing vaginal bleeding for 10 days, and the bleeding had become particularly heavy in the past three days. She had also felt generally unwell for around a week with malaise, fatigue, headaches, anorexia, and vomiting.

She and her partner had been trying to conceive. Her last menstrual period had been 10 weeks ago and she had recently tested positive with a urinary ( human chorionic gonadotrophin) pregnancy testing kit. She had three children from a previous partner. Two of these pregnancies were complicated by hypertension from 36 weeks onwards. She thought that she may have had two miscarriages the previous year, which had not been investigated.

The previous year she had a measured blood pressure of 165/90 mm Hg. She gave a history suggestive of Raynaud's syndrome but had no other symptoms or past medical . . . [Full text of this article]

Questions

Related Articles

A patient with suspected miscarriage is found to have hypertension, renal failure, and thrombocytopenia: case outcome

Chris M Laing, Rhys Roberts, Liz Lightstone, Alison Graham, Terry H Cook, Shaun Summers, and Charles D Pusey
BMJ 2007 335: 205-206. [Extract] [Full Text] [PDF]

Commentary: Nephrologist

Robin Woolfson
BMJ 2007 335: 206-207. [Extract] [Full Text] [PDF]

Commentary: View from clinical education

Ed Peile
BMJ 2007 335: 207-208. [Extract] [Full Text] [PDF]

Commentary: Author's reply

Chris M Laing
BMJ 2007 335: 208. [Extract] [Full Text] [PDF]

A patient with suspected miscarriage is found to have hypertension, renal failure, and thrombocytopenia
BMJ 2007 335: 0. [Extract] [Full Text]

A patient with suspected miscarriage is found to have hypertension, renal failure, and thrombocytopenia: case progression

Chris M Laing, Rhys Roberts, Liz Lightstone, Alison Graham, Terry H Cook, Shaun Summers, and Charles D Pusey
BMJ 2007 335: 44. [Extract] [Full Text] [PDF]

Rapid Responses:

Read all Rapid Responses

HELLP syndrome

Dr. Cristina Verdaguer
bmj.com, 29 Jun 2007 [Full text]

Interactive case report

DAVID GWYNFOR SAMUEL
bmj.com, 29 Jun 2007 [Full text]

I'm glad the patient is there.

Robert Bernstein
bmj.com, 30 Jun 2007 [Full text]

Endothelial disorder

David Mowbray
bmj.com, 1 Jul 2007 [Full text]

Possible suggestions would be-

Prasanta Padhan
bmj.com, 1 Jul 2007 [Full text]

TTP

Catie Butchart
bmj.com, 1 Jul 2007 [Full text]

Stabilise then investigate

Alasdair I Moonie
bmj.com, 1 Jul 2007 [Full text]

Antiphospholipid syndrome +/- SLE???

Vijay Zawar
bmj.com, 2 Jul 2007 [Full text]

Delay in starting the plasma exchange = treatment failure

Hawraman Ramadan
bmj.com, 2 Jul 2007 [Full text]

Systematic approach is necessary

Rishu Tandon
bmj.com, 2 Jul 2007 [Full text]

Hypertension is the key

C M Morgan
bmj.com, 2 Jul 2007 [Full text]

Author interjection

Chris M Laing
bmj.com, 3 Jul 2007 [Full text]

? secondary TTP (related to collagen vascular disease)

Thein H Oo, MD, FRCP
bmj.com, 3 Jul 2007 [Full text]

hellp

w afzal
bmj.com, 4 Jul 2007 [Full text]

???Scleroderma renal crisis

a anon
bmj.com, 4 Jul 2007 [Full text]

TTP/HUS

Seema Chakravarti
bmj.com, 4 Jul 2007 [Full text]

???Scleroderma renal crisis - Addendum to ? secondary TTP (related to collagen vascular disease)

Thein H Oo, MD, FRCP
bmj.com, 4 Jul 2007 [Full text]

Catastrophic antiphospholipid syndrome

Ken K Hodson
bmj.com, 4 Jul 2007 [Full text]

Interactive case report: SLE most likely diagnosis

fergus j dignan
bmj.com, 5 Jul 2007 [Full text]

Underlying connective tissue disorder

Faisal Mohammad
bmj.com, 8 Jul 2007 [Full text]