Development of severe thrombocytopenia 3 months after delivery complicated with early-onset preeclampsia: a case report

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We report a case of preeclampsia with severe organ dysfunction, diagnosed conclusively as antiphospholipid syndrome (APS), following the onset of severe thrombocytopenia 3 months after delivery.

A 21-year-old female (gravida 1, para 0) delivered preterm at 31 weeks of gestation due to preeclampsia. During pregnancy, hypertension remained in the mild range (<160/100 mmHg) during the day, but proteinuria (12.5 g/gCre) and thrombocytopenia (51,000/μl) were severe. After delivery, proteinuria and platelet count improved rapidly, but at 3 months after delivery, platelet count fell to 15,000/μl. Diagnostic workup for the cause of thrombocytopenia revealed positive lupus anticoagulants. The patient was diagnosed with APS based on her pregnancy course and positive antiphospholipid antibodies.

Long-term follow-up is imperative for patients with early-onset preeclampsia with severe organ dysfunction, even if their clinical symptoms improve.