血液学のトピックス：血液学問題

TOPICS IN HEMATOLOGY: Hernatology Problem

　24歳の女性が早期分娩のために入院した．妊娠第3期の間中軽度の血圧上昇が認められ，更に4年前の最初の妊娠後直ちに高血圧を来したという既往歴があった．入院時の彼女の血圧は最高血圧が210，最低血圧が120であり，この高血圧は，3ポンド9オンスの児を出産した後も持続した．

　分娩後第1日目に痙攣発作，黄疸と尿排泄量が428ccという乏尿が起こった．

A 24-year-old female was admitted to the hospital in premature labor^*1. Her history revealedslightly elevated blood pressure during the last trimester of pregnancy^*2 and hypertension immediately following her first pregnancy four years ago. Upon admission^*3 her blood pressurewas 210/120 and it remained elevated following the delivery of a three pound, nineounce maleinfant. She developed seizures, jaundice and oliguria^*4 with an output of 428cc of urine onher first postpartum day. Laboratory findings are summarized in Table I. Blood smears fromthe first postpartum week are illustrated in Figures 1-3. The patient continued to be hypertensive despite the use of antihypertensive drugs*5 and her mental state deteriorated to confusion, drowsiness, and regressive behavior. She continued to have periodic seizures. Theoliguria progressed to anuria and peritoneal dialysis*6 was required.