A patient with suspected miscarriage is found to have hypertension, renal failure, and thrombocytopenia: case progressionBMJ 2007; 335 doi: https://doi.org/10.1136/bmj.39239.478495.80 (Published 05 July 2007) Cite this as: BMJ 2007;335:44
- Chris M Laing, specialist registrar in nephrology1,
- Rhys Roberts, senior house officer in medicine2,
- Liz Lightstone, consultant nephrologist1,
- Alison Graham, consultant radiologist3,
- Terry H Cook, professor of renal pathology4,
- Shaun Summers, specalist registrar in nephrology and internal medicine1,
- Charles D Pusey, professor of medicine5
- 1West London Renal and Transplant Centre, Hammersmith Hospital, London W12 0HS
- 2Department of Medicine, Hammersmith Hospital, London W12 0HS
- 3Department of Radiology, Hammersmith Hospital
- 4Division of Investigative Science, Imperial College London, Hammersmith Hospital Campus, London W12 0NN
- 5Division of Medicine, Imperial College London, Hammersmith Hospital Campus
- Correspondence to: Chris M Laing
- Accepted 2 April 2007
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 …
Log in using your username and password
Log in through your institution
Register for a free trial to thebmj.com to receive unlimited access to all content on thebmj.com for 14 days.
Sign up for a free trial