PP30 - HELLP SYNDROME AS A MASQUERADE FOR LEPTOSPIROSIS WITHOUT FEVER IN PREGNANCY : A CASE REPORT. Poster #33

Shea Chuen KHOO
Hospital Tuanku Fauziah, Perlis, Malaysia.

Shafarul Halimi Bin MOHAMED
Hospital Tuanku Fauziah, Perlis, Malaysia.

Shea Khean KHOO
Hospital Tuanku Fauziah, Perlis, Malaysia.

Objective(s):
To present a rare case on how a clinical manifestation of HELLP syndrome masquerading the underlying atypical leptospirosis infection (without fever) in a pregnant lady.

Methodology:

Results:

Discussion and Conclusions
Managing pregnant patients with acute liver dysfunction or transaminitis can be challenging. HELLP (Haemolysis, Elevated Liver enzymes levels, and Low Platelet levels) syndrome can be one of the manifestation in these patients. Apart from managing HELLP syndrome with supportive therapies, it is vital to look for any potential cause of the HELLP syndrome, so as to treat it promptly, to avoid or minimise complications happening both mothers and fetuses. In this case, we are reporting a case where a pregnant lady who almost approached 20 weeks of gestational age, presented with some gastrointestinal symptoms and uncontrolled hypertension, and was diagnosed as HELLP syndrome. Further tests revealed Leptospirosis being the underlying cause of her HELLP syndrome manifestation, and therefore was treated with antibiotics (ceftriaxone). However, she eventually had miscarriage 1 day after the completion of antibiotics. This case report is worthwhile for sharing in the world of medical literature, not only because of the rarity of diagnosing leptospirosis in pregnant ladies, but also for leptospirosis to be a possible aetiology for HELLP syndrome. This revealed the need of looking for a treatable cause and thus initiating treatment for the HELLP syndrome, rather than proceeding for termination of pregnancy promptly, should patient’s condition worsen. Also, it is interesting to note that the case illustrated here did not present with fever, demonstrating the possibility of leptospirosis infection manifesting without the sign of fever.