BMJ  2007;335:44 (7 July), doi:10.1136/bmj.39239.478495.80

Practice

Interactive case report

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

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

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

Last week (30 June; doi: 10.1136/bmj.39212.564745.BE) we described the case of a 46 year old woman who presented after a possible miscarriage with severe hypertension, acute renal failure, alveolar infiltrates on chest radiography, thrombocytopenia, and grand mal convulsions.

Initially, she was given an intravenous infusion of lorazepam, frusemide, and a nitrate. A computed tomography scan of the brain excluded acute haemorrhage. She was then transferred to the renal unit of the Hammersmith Hospital.

On arrival, she remained severely hypertensive at 200/120 mm Hg. Fundoscopy demonstrated flame haemorrhages and papillo-oedema. She had severe peripheral and pulmonary oedema. Urine microscopy demonstrated red blood cells but no red cell casts. Her haemoglobin continued to fall to 8.4 g/l, with 11% reticulocytes, and her creatinine rose to 709 µmol/l.

We thought that thrombocytopenia, red cell fragmentation on blood film, raised bilirubin concentrations, and raised lactate dehydrogenase concentrations were consistent with a diagnosis of . . . [Full text of this article]

Questions

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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]

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 presentation

Chris M Laing, Rhys Roberts, Liz Lightstone, Alison Graham, Terry H Cook, Shaun Summers, and Charles D Pusey
BMJ 2007 334: 1372. [Extract] [Full Text] [PDF]

Rapid Responses:

Read all Rapid Responses

Malignant hypertension

Mohammad A. Al-Jubouri
bmj.com, 6 Jul 2007 [Full text]

Why resist antibiotics?

Robert M Bernstein
bmj.com, 8 Jul 2007 [Full text]

Reversible posterior leucoencephalopathy syndrome / Accelerated hypertension

Marcela P. Vizcaychipi, et al.
bmj.com, 8 Jul 2007 [Full text]

Prompt therapy is vital

Prasanta Padhan
bmj.com, 8 Jul 2007 [Full text]

PRES with accelerated hypertension

Adam P Morton
bmj.com, 9 Jul 2007 [Full text]

Key is regulated BP reduction

Faisal Mohammad
bmj.com, 9 Jul 2007 [Full text]

Progressive multifocal leucoencephalopathy possibly due to her underlying SLE!

Kathir Yoganathan, et al.
bmj.com, 10 Jul 2007 [Full text]

PREP?! Query cause

DAVID GWYNFOR SAMUEL
bmj.com, 11 Jul 2007 [Full text]

Hypertensive Encephalopathy with Background Collagen Disorder

Chandra M. Jha, et al.
bmj.com, 14 Jul 2007 [Full text]

Malignant hypertension with underlying disease

Dr. Cristina Verdaguer
bmj.com, 16 Jul 2007 [Full text]