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Stillbirth and fulminant postpartum haemolysis: COVID-19 or leptospirosis or both?
We report the case of a female patient with a SARS-CoV-2 infection first diagnosed at 32 2/7 weeks of gestation, resulting in stillbirth at 33 5/7 weeks of gestation. Post partum the patient presented with severe and persistent haemolysis, mild thrombocytopaenia, renal insufficiency and proteinuria...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10314429/ https://www.ncbi.nlm.nih.gov/pubmed/37399345 http://dx.doi.org/10.1136/bcr-2022-252620 |
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author | Sutter, Tabea Fehr, Thomas Blume, Carolin Kajdi, Marie-Elisabeth |
author_facet | Sutter, Tabea Fehr, Thomas Blume, Carolin Kajdi, Marie-Elisabeth |
author_sort | Sutter, Tabea |
collection | PubMed |
description | We report the case of a female patient with a SARS-CoV-2 infection first diagnosed at 32 2/7 weeks of gestation, resulting in stillbirth at 33 5/7 weeks of gestation. Post partum the patient presented with severe and persistent haemolysis, mild thrombocytopaenia, renal insufficiency and proteinuria as well as elevated liver enzymes and jaundice. Further investigations revealed a positive IgM for Leptospira interrogans and proof of infection by PCR in the urine. The patient was treated with penicillin for 7 days and received a total of 23 units of red blood cells within 11 days. Haemolysis diminished over time and haemoglobin, proteinuria and transaminases normalised within 23 days after delivery. We suppose an acute leptospirosis as underlying cause for the haemolysis, mimicking pregnancy-associated thrombotic microangiopathy. Whether stillbirth was related to leptospirosis or SARS-CoV-2 infection remains unclear. |
format | Online Article Text |
id | pubmed-10314429 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-103144292023-07-02 Stillbirth and fulminant postpartum haemolysis: COVID-19 or leptospirosis or both? Sutter, Tabea Fehr, Thomas Blume, Carolin Kajdi, Marie-Elisabeth BMJ Case Rep Case Reports: Reminder of important clinical lesson We report the case of a female patient with a SARS-CoV-2 infection first diagnosed at 32 2/7 weeks of gestation, resulting in stillbirth at 33 5/7 weeks of gestation. Post partum the patient presented with severe and persistent haemolysis, mild thrombocytopaenia, renal insufficiency and proteinuria as well as elevated liver enzymes and jaundice. Further investigations revealed a positive IgM for Leptospira interrogans and proof of infection by PCR in the urine. The patient was treated with penicillin for 7 days and received a total of 23 units of red blood cells within 11 days. Haemolysis diminished over time and haemoglobin, proteinuria and transaminases normalised within 23 days after delivery. We suppose an acute leptospirosis as underlying cause for the haemolysis, mimicking pregnancy-associated thrombotic microangiopathy. Whether stillbirth was related to leptospirosis or SARS-CoV-2 infection remains unclear. BMJ Publishing Group 2023-06-30 /pmc/articles/PMC10314429/ /pubmed/37399345 http://dx.doi.org/10.1136/bcr-2022-252620 Text en © BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ. |
spellingShingle | Case Reports: Reminder of important clinical lesson Sutter, Tabea Fehr, Thomas Blume, Carolin Kajdi, Marie-Elisabeth Stillbirth and fulminant postpartum haemolysis: COVID-19 or leptospirosis or both? |
title | Stillbirth and fulminant postpartum haemolysis: COVID-19 or leptospirosis or both? |
title_full | Stillbirth and fulminant postpartum haemolysis: COVID-19 or leptospirosis or both? |
title_fullStr | Stillbirth and fulminant postpartum haemolysis: COVID-19 or leptospirosis or both? |
title_full_unstemmed | Stillbirth and fulminant postpartum haemolysis: COVID-19 or leptospirosis or both? |
title_short | Stillbirth and fulminant postpartum haemolysis: COVID-19 or leptospirosis or both? |
title_sort | stillbirth and fulminant postpartum haemolysis: covid-19 or leptospirosis or both? |
topic | Case Reports: Reminder of important clinical lesson |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10314429/ https://www.ncbi.nlm.nih.gov/pubmed/37399345 http://dx.doi.org/10.1136/bcr-2022-252620 |
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