17. gebelik haftasında akut kolesistit atağı ve sistemik lupus eritematozus ile birlikte görülen erken başlangıçlı hellp sendromu

Hellp sendromu, preeklampsinin atipik, şiddetli ve hayatı tehdit eden bir formu olup genellikle hemoliz, yüksek karaciğer enzimleri ve düşük platelet düzeyleri ile ilişkilidir. Ayrıca, belirgin maternal ve perinatal mortaliteye de neden olduğundan önemi büyüktür. Hellp sendromunun hemen her zaman gebeliğin 20. haftadan önce meydana geldiği bilinmektedir. Fakat bazı eşlik eden hastalıkların varlığında hellp sendromu veya şiddetli preeklampsi daha erken gebelik haftalarında da görülebilir. Bu durum aynı zamanda tanısal zorluğa da neden olur. Biz bu olguda, 17. Gebelik haftasında hellp sendromu gelişen bir sistemik lupus eritematozus (SLE) hastasının tanı ve tedavi periodunu anlattık. Çalışmamız; hellp sendromunun SLE ya da akut kolesistit gibi eşlik eden hastalıklar varlığında tespit edilmesinin zorluğuna ve şaşırtıcı olarak erken gebelik haftalarında meydana gelebilmesine dikkat çekmektedir. Aynı zamanda, böyle olgularda, birçok hastalık hellp sendromunu taklit edebileceğinden ayırıcı tanı da çok önemlidir.

Anahtar Kelimeler:

hellp sendromu, sistemik lupus eritematozus, erken başlangıç, karaciğer enzimleri

EARLY ONSET HELLP SYNDROME WITH SYSTEMİC LUPUS ERYTEMATOSUS AND ACUTE CHOLECYSTİTİS ATTACK AT 17TH WEEK OF GESTATİON

Hellp syndrome is an atypic, severe and life threatening form of preeclapmsia, which is usually associated with hemolysis, elevated liver enzymes and low platelet count. Also it is very important because it causes significantly maternal and perinatal mortality. It is known that hellp syndrome almost always occurs after 20 weeks of gestation. But in the presence of some accompanying diseases, hellp syndrome or severe preeclampsia can occur at earlier gestational weeks. This may also lead to diagnostic difficulties. In this case, we described the diagnosis and recovery period of a systemic lupus erytematosus (SLE) patient who developed hellp syndrome at 17 weeks of gestation. Our experience takes attention that detection of hellp syndome accompanying diseases like systemic lupus erytematosus or acute cholecystitis can be difficult and it can occur distinctly at earlier weeks of gestation. Also the differential diagnosis is very important in such cases, because many diseases can mimic hellp syndrome.

Keywords:

hellp syndrome, systemic lupus erytematosus, early onset, liver enzymes,

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