Autoimmunity, preeclampsia and splenic rupture: a case report and literature review

Abstract

Antiphospholipid antibody (APLA) syndrome is an autoimmune disease which is associated with preeclampsia and can cause thromboembolic events in several organs including the spleen. This report includes a case of post-partum splenic rupture in a woman with preeclampsia in the presence of APLA syndrome and a literature review of splenic rupture during the third trimester and puerperium. Unlike the prominent clinical manifestation of liver hematoma and rupture during preeclampsia, rupture of the spleen can be silent and mistakenly underdiagnosed.

Spontaneous rupture of the spleen at full term during pregnancy: a case report

“…Sudden-onset abdominal pain has been reported to be a principal symptom of patients who experience a rupture of the spleen during the third trimester of pregnancy. 8 The affected patients may report pain in their left upper abdomen, back, left subscapular area, or left hypochondriac region; and in addition may show myotonia of the abdominal musculature, hemorrhagic shock, and other signs; but generally do not report obstetric symptoms, such as vaginal bleeding and fluid flow. Furthermore, the large uterus may restrict the blood flow to the parietal peritoneum, leading to minor signs of peritoneal irritation during the early stage of the disease; and the diagnosis may be missed because abdominal pain owing to splenic rupture may be confused with labor pains.…”

Splenic vessel bleeding in puerperium: a rare maternal near miss case

“…7 Cases of splenic rupture with pre-eclampsia, autoimmunity and antiphopholipid antibody syndrome have been reported in literature. 8 Although the association between preeclampsia and hepatic subcapsular or ruptured hematoma is well understood, the association with splenic rupture is rare. Similarly, our case had pre-eclampsia which could be the cause of spontaneous splenic hemorrhage.…”