The patient is initially diagnosed with pre-eclampsia or HELLP syndrome. On day 4 postpartum, she requires transfer to ICU for renal replacement therapy.
Q: What additional diagnoses should be considered at this point?
A: While pre-eclampsia and HELLP syndrome are common obstetric complications, the rapid progression to renal failure requiring dialysis should prompt consideration of other diagnoses, including:
- Acute Fatty Liver of Pregnancy (AFLP)
- Thrombotic Thrombocytopenic Purpura (TTP)
- Haemolytic Uremic Syndrome (HUS)
- Sepsis with multi-organ dysfunction
- Amniotic fluid embolism
In this case, the patient's condition deteriorated rapidly, with CT findings showing "small bilateral pleural effusions, minor left consolidation, and moderate ascites throughout the abdomen and pelvis". These findings, combined with the need for renal replacement therapy, suggest a more severe underlying condition than initially suspected.
