Question

A pregnant lady with 34 weeks of amenorrhea has the following findings: LDH- 700 IU/L, platelets – 75,000/mm3, serum bilirubin- 1.5mg/dL, SGOT-200 U/L, SGPT-150U/L, and BP -140/96 mm Hg. Her coagulation profile and renal function tests are normal. What is the diagnosis?
LDH- Lactate dehydrogenase
SGOT- Serum glutamic-oxaloacetic transaminase / AST- Asparate transaminase
SGPT- Serum glutamic pyruvic transaminase / ALT- Alanine transaminase

• A. HELLP syndrome
• B. Acute fatty liver of pregnancy
• C. Viral hepatitis
• D. Intrahepatic cholestasis

Answer 1

The Correct Option is A

The scenario presents a 34-week pregnant woman with specific laboratory findings and clinical features. Analyzing these findings will help us reach a diagnosis.

• LDH (Lactate dehydrogenase): Elevated at 700 IU/L
• Platelets: Low count at 75,000/mm³
• Serum bilirubin: Slightly elevated at 1.5 mg/dL
• SGOT (AST): Elevated at 200 U/L
• SGPT (ALT): Elevated at 150 U/L
• Blood Pressure: High at 140/96 mm Hg

Normal coagulation profile and normal renal function tests are noted. These features are typically seen in:

HELLP Syndrome

HELLP syndrome is a serious pregnancy complication usually considered a variant of preeclampsia. It is characterized by:

• Hemolysis (Elevated LDH indicates hemolysis)
• Elevated Liver enzymes (Increased SGOT and SGPT)
• Low Platelet count (Thrombocytopenia)

The elevated blood pressure adds to the likelihood of this diagnosis. Given the laboratory and clinical findings, HELLP syndrome is the most fitting diagnosis.