A 26-year-old primigravid woman at 20 weeks gestation comes to the emergency department due to joint pain and swelling in her
hands and feet over the past day. The patient reports good fetal movement and has no abdominal pain, bleeding, leakage of fluid,
headaches, or visual changes. She has a history of systemic lupus erythematosus that was managed with hydroxychloroquine, which
the patient stopped taking prior to conception Blood pressure is 150/95 mm Hg; 5 minutes later, following rest in the lateral
recumbent position, it is 140/95 mm Hg Fetal heart rate by Doppler ultrasound is 145/min. Physical examination shows bilateral 2+
pitting edema of the legs and a red macular eruption on the cheeks. Laboratory results are as follows:
Hemoglobin 10.2 g/dL
Platelets 120,000/mm3
Urinalysis 2+ protein, RSC casts
Urine protein (24 hour) 1.5 g
Blood urea nitrogen 28 mg/dL
Serum creatinine 2.1 mg/dL
Lactate dehydrogenase 62 U/L
Serum electrolytes, liver function tests, and coagulation studies are within normal limits. Which of the f ollowing is the most likely
diagnosis for this patient?
- QA Gestational hypertension
- 0 B. HELLP syndrome
- 0 C. Hemolytic uremic syndrome
- 0 D. Preeclampsia
- 0 E. Systemic lupus erythematosus flare
0 voters