Ann Kinga Malinowski1,2,3, Jacqueline Parrish1, Rohan D'Souza1,2,3, Kevin Hm Kuo2,4, Richard Ward2,4, Nadine Shehata2,5,6,7,8. 1. Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynaecology, Mount Sinai Hospital, Toronto, Canada. 2. Department of Medicine, University of Toronto, Toronto, Canada. 3. Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada. 4. Division of Haematology, Department of Medicine, University Health Network, Toronto, Canada. 5. Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada. 6. Division of Haematology, Department of Medicine, Mount Sinai Hospital, Toronto, Canada. 7. Division of Medical Oncology and Haematology, Department of Medicine, University Health Network, Toronto, Canada. 8. Department of Laboratory Medicine and Pathobiology, Mount Sinai Hospital, Toronto, Canada.
Abstract
BACKGROUND: Acute splenic sequestration crisis, characterized by abrupt fall in hemoglobin, splenomegaly, hypovolemia, and often thrombocytopenia, occurs infrequently in adults with sickle cell disease and extremely rarely during pregnancy. CASE: A 25-year-old woman with HbSC presented at 33 weeks' gestation with vaso-occlusive pain. Sudden worsening of abdominal pain and non-reassuring fetal surveillance on day 3 of admission led to emergent delivery. Acute splenic sequestration crisis was the diagnosis of exclusion based on clinical presentation and intra-operative hemoglobin of 37 g/L. Five- and 10-minute Apgar scores were 4. Neonatal brain magnetic resonance imaging revealed significant diffuse white matter abnormalities. CONCLUSION: Acute splenic sequestration crisis in pregnancy must be considered in the differential diagnosis for this patient population as it can evolve rapidly and lead to maternal and fetal compromise.
BACKGROUND: Acute splenic sequestration crisis, characterized by abrupt fall in hemoglobin, splenomegaly, hypovolemia, and often thrombocytopenia, occurs infrequently in adults with sickle cell disease and extremely rarely during pregnancy. CASE: A 25-year-old woman with HbSC presented at 33 weeks' gestation with vaso-occlusive pain. Sudden worsening of abdominal pain and non-reassuring fetal surveillance on day 3 of admission led to emergent delivery. Acute splenic sequestration crisis was the diagnosis of exclusion based on clinical presentation and intra-operative hemoglobin of 37 g/L. Five- and 10-minute Apgar scores were 4. Neonatal brain magnetic resonance imaging revealed significant diffuse white matter abnormalities. CONCLUSION: Acute splenic sequestration crisis in pregnancy must be considered in the differential diagnosis for this patient population as it can evolve rapidly and lead to maternal and fetal compromise.
Authors: Bernard A Davis; Shubha Allard; Amrana Qureshi; John B Porter; Shivan Pancham; Nay Win; Gavin Cho; Kate Ryan Journal: Br J Haematol Date: 2016-11-18 Impact factor: 6.998
Authors: Samir K Ballas; Susan Lieff; Lennette J Benjamin; Carlton D Dampier; Matthew M Heeney; Carolyn Hoppe; Cage S Johnson; Zora R Rogers; Kim Smith-Whitley; Winfred C Wang; Marilyn J Telen Journal: Am J Hematol Date: 2010-01 Impact factor: 10.047