Successful management of a pregnant woman with Kasabach-Merritt syndrome and preeclampsia: A case report

Medicine (Baltimore). 2020 Jul 10;99(28):e21198. doi: 10.1097/MD.0000000000021198.

Abstract

Introduction: Kasabach-Merritt Syndrome (KMS) is an extremely rare disease in adults, which lead to consumptive coagulopathy characterized by severe hypofibrinogenemia and thrombocytopenia. PATIENT CONCERNS:: a 25-year-old Chinese pregnant women complicated by preeclampsia and KMS presented with refractory postpartum hemorrhage and incision bleeding after cesarean section.

Diagnosis: The diagnosis of KMS was made based on clinical manifestation of Kaposiform Hemangioendothelioma, severe hypofibrinogenemia and thrombocytopenia.

Interventions: After a poor response to massive blood products transfusion for 1 week, corticosteroid treatment was initiated for 3 days.

Outcomes: The patient reached a normal platelet count and a mild anemia within 4 weeks. Two months later, all laboratory values had returned to normal, and the incision was healing well.

Conclusion: Pregnancy complicated by preeclampsia and surgery may have contributions for the development of Kasabach-Merritt syndrome. Corticosteroid is indicated in the episode of acute Kasabach-Merritt syndrome after the failure of massive blood transfusion.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Adult
  • Cesarean Section
  • Female
  • Humans
  • Kasabach-Merritt Syndrome / complications
  • Kasabach-Merritt Syndrome / therapy*
  • Postpartum Hemorrhage / drug therapy*
  • Postpartum Hemorrhage / etiology
  • Pre-Eclampsia / etiology
  • Pre-Eclampsia / therapy*
  • Pregnancy
  • Pregnancy Complications, Hematologic / etiology
  • Pregnancy Complications, Hematologic / therapy*

Substances

  • Adrenal Cortex Hormones