Acute Hemolysis and Thrombocytopenia in Eclampsia

Report of a Case

Abstract

A fatal case of eclampsia is reported in which intravascular hemolysis and thrombocytopenia were early, severe, and baffling complications, in addition to the typical glomerular endothelial swelling, periportal hemorrhagic necrosis of the liver, and less common intracerebral hemorrhage. Hemolysis and thrombocytopenia are frequently unappreciated components of toxemia of pregnancy. Altered lipid metabolism in the genesis of toxemias of pregnancy has been suggested experimentally. Associated changes in cell membranes may be responsible for intravascular fibrin deposition resulting in glomerular ischemia, which contributes not only to the albuminuria with consequent extravascular fluid retention, but also to the hypertension which is important in the pathogen esis of the convulsions and, with thrombocytopenia and other possible factors, accounts for the intracerebral hemorrhage seen in 30% of fatal cases of eclampsia.