[A 28-Week-Pregnant Woman at Twenty Years of Age, Who Had Been Hospitalized with Jaundice]

Rinsho Byori. 2016 Sep;64(9):1091-1098.
[Article in Japanese]

Abstract

The Reversed Clinicopathological Conference (R-CPC) is a useful tool to analyze a patient's condition us- ing only laboratory data. An R-CPC was held at the 59th Regional Congress. One case presenter, two dis- cussers, and one commenter participated in this R-CPC. We report a 28-week-pregnant woman at twenty years of age, who had been hospitalized with jaundice. In laboratory data, AST, ALT, and bilirubin were ele- vated and the prothrombin time (PT) and activated partial thromboplastin time (APTT) were prolonged. Although the liver failure was improved after she delivered a baby by Caesarean section, postoperative intra- peritoneal bleeding persisted. The diagnosis based on liver biopsy was autoimmune hepatitis. Although the bleeding was stopped on the seventh postoperative day, the prolongation of PT and APTT remained. LA was positive in the diluted Russell's viper venom time. Anti-cardiolipin and anti-beta-2-glycoprotein anti- bodies were also positive. The prothrombin activity was reduced. A high titer of phosphatidylserine- dependent anti-prothrombin antibody (aPS/PT), which causes bleeding, was observed. Based on these data, she was diagnosed with lupus anticoagulant-hypothrombinemia syndrome (LAHS). The 2 discussers care- fully analyzed the laboratory data and the commenter gave appropriate opinions. [Review].

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Female
  • Hepatitis, Autoimmune / complications*
  • Humans
  • Jaundice / etiology*
  • Lupus Coagulation Inhibitor*
  • Pregnancy
  • Pregnancy Complications*
  • Pregnancy Trimester, Third
  • Prothrombin Time

Substances

  • Lupus Coagulation Inhibitor