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Revista Española de Anestesiología y Reanimación (English Edition)
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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Bilateral serous retinal detachment in a patient with atypical presentation of p...
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Vol. 69. Issue 2.
Pages 114-118 (February 2022)
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Vol. 69. Issue 2.
Pages 114-118 (February 2022)
Case report
Bilateral serous retinal detachment in a patient with atypical presentation of preeclampsia due to HELLP syndrome
Desprendimiento de retina exudativo bilateral en paciente con presentación atípica de preeclampsia por síndrome de HELLP
P. Sánchez Zamora
Corresponding author
pszhso@yahoo.es

Corresponding author.
, R.A. Mejía Arnaud, R. Saz Castro, B. Gómez del Pulgar Vázquez, J.J. Correa Barrera
Servicio de Anestesiología y Reanimación, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
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Table 1. Laboratory parameters at admission/in the recovery room, and at hospital discharge.
Table 2. Differential diagnosis of pregnancy-associated kidney injury.
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Abstract

Exudative retinal detachment (ERD) is a rare complication that occurring in 1% of patients with preeclampsia, its incidence is increased when it is associated with HELLP syndrome.

Preeclampsia is defined by the development of arterial hypertension and proteinuira occurs after 20 weeks of gestation until postpartum. HELLP syndrome (low platelets, hemolysis and elevated liver enzymes) is a severe form of preeclampsia.

ERD in preeclampsia is related to choroidal ischaemia, in the vast majority of the cases associated with hypertensive retinopathy. However, it has been proposed that the combination of hypertension with a microangiopathic hemolysis, hipercoagulability and hypoalbuminemia are the main factors contributing to the development of ERD.

Its treatment includes a rapid resolution of labor to reverse ocular manifestations and prevent visual sequels.

We describe the case of a pregnant woman with atypical preeclampsia who, in the postpartum of a cesarean, presented an ERD concomitantly with a HELLP syndrome.

Keywords:
Exudative retinal detachment
Severe preeclampsia
HELLP syndrome
Atypical preeclampsia
Arterial hypertension
Resumen

El desprendimiento de retina exudativo (DRE) es una rara complicación que afecta al 1% de preeclampsias, aumentando su incidencia cuando se asocia con síndrome de HELLP.

La preeclampsia se define por el inicio de hipertensión arterial y proteinuria tras la 20.ª semana de gestación hasta el posparto. EL síndrome de HELLP (trombocitopenia, hemólisis y elevación de enzimas hepáticas) constituye una forma severa de preeclampsia.

El DRE en la preeclampsia está relacionado con isquemia coroidal, en la mayoría de los casos asociado a retinopatía hipertensiva. Sin embargo, se ha propuesto que la combinación de hipertensión junto a microangiopatía hemolítica, hipercoagulabilidad e hipoalbuminemia son los principales factores implicados en el DRE.

Su tratamiento incluye una resolución rápida del parto para revertir las manifestaciones oculares y prevenir secuelas visuales.

Se describe el caso de una gestante con preeclampsia atípica que, en el posparto de una cesárea, presentó un DRE concomitante con un síndrome de HELLP.

Palabras clave:
Desprendimiento de retina exudativo
Preeclampsia severa
Síndrome de HELLP
Preeclampsia atípica
Hipertensión arterial

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