Gestational Diabetes Mellitus Complicated by Hemolysis, Elevated Liver Enzymes, and Low Platelet Count After Decreased Need for Insulin: 2 Cases

Yoshimasa Kawarai; Shogo Kaneko; Masataka Kagimoto; Ayaka Kaneko; Naoki Ichii; Kaoru Kakinuma; Koyomi Saito; Motomasa Ihara; Toshiyuki Kakinuma; Michitaka Ohwada; Hirokazu Tanaka

doi:10.12659/AJCR.933460

08 November 2021 : Case report Japan

Gestational Diabetes Mellitus Complicated by Hemolysis, Elevated Liver Enzymes, and Low Platelet Count After Decreased Need for Insulin: 2 Cases

Unusual clinical course, Diagnostic / therapeutic accidents

Yoshimasa Kawarai^12ABCDEF*, Shogo Kaneko^3B, Masataka Kagimoto^2B, Ayaka Kaneko^2B, Naoki Ichii^2B, Kaoru Kakinuma^2B, Koyomi Saito^2B, Motomasa Ihara^12B, Toshiyuki Kakinuma^2B, Michitaka Ohwada^2B, Hirokazu Tanaka^12BDF

DOI: 10.12659/AJCR.933460

Am J Case Rep 2021; 22:e933460

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Table 2. Results of biochemical blood tests in 2 patients suspected of developing HELLP/AFLP.

	Unit	Reference range	Case 24			Case 28
	Unit	Reference range	2 wk before CS	1 wk before CS	Just before CS	2 wk before CS	Just before CS
WBC	/μL		6660	5830	6740	7780	10470
Hb	g/dL	11.2–15.2	13.1	12.6	12.2	11.9	11.6
Plt	×10000/μL	14.0–37.9	13	13.9	5.6	18.4	8.8
PT	sec	8.0–12.0			12.9		12.1
APTT	sec	26.0–38.0			27.3		28.7
Fibrinogen	mg/dL	200–400			539
AT activity	%	80–120			93.2		82
AST	IU/L	8–38	14	17	115		150
ALT	IU/L	4–44	19	27	146		149
T-Bil	mg/dL	0.2–1.2	0.7	0.7	1.9		0.9
LDH	IU/L	106–211	151	150	482		352
Cre	mg/dL	0.47–0.79	0.57	0.59	0.63		0.55
BUN	mg/dL	8.0–20.0	4.3	5.2	5.2		8.1
HELLP – hemolysis, elevated liver enzymes, and low platelet syndrome; AFLP – acute fatty liver of pregnancy; WBC – white blood cell; Hb – hemoglobin; Plt – platelet; PT – parathyroid; APTT – activated partial thromboplastin time; AT – antithrombin; AST – aspartate aminotransferase; ALT – alanine aminotransferase; T-Bil – total bilirubin; LDH – lactate dehydrogenase; Cre – creatinine; BUN – blood urea nitrogen.

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Gestational Diabetes Mellitus Complicated by Hemolysis, Elevated Liver Enzymes, and Low Platelet Count After Decreased Need for Insulin: 2 Cases

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