Sickle cell anaemia in vaso-occlusive crisis and acute fatty liver of pregnancy: a case report

  • Michael C. Ezeanochie Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital, Benin city, Edo State, Nigeria
  • Oghenefegor E. Olokor Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital, Benin city, Edo State, Nigeria
  • Ofure E. Yamah Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital, Benin city, Edo State, Nigeria
Keywords: Vaso-occlusive crises; acute fatty liver of pregnancy; hypoglycaemia; Sickle-cell anaemia

Abstract

Acute fatty liver of pregnancy (AFLP) is an uncommon condition that manifests in the third trimester of pregnancy.Its association with vaso-occlusive crisis from Sickle Cell Anaemia is not common. Published data on the simultaneous occurrence of these two conditions is rare, hence this case report. A 32-year-old gravida 3 para 1+1 lady, with Sickle Cell Anaemia, had a vaso-occlusive crisis in association with AFLP at 32 weeks’ gestation, and the outcome of her management was successful. AFLP is a rare late-gestational event affecting about 1 in 10,000 to 15,000 pregnancies. The exact aetiology is not known. Profound hypoglycaemia and jaundice with elevated serum transaminases are recognized features of AFLP.These features may also be seen in haemoglobinopathies. The simultaneous occurrence of AFLP and Sickle Cell Anaemia may result in overlap of symptoms and delay in diagnosis and treatment. Therefore, maintaining a high index of suspicion is key. The cornerstone for treatment remains prompt delivery and supportive care. AFLP can coexist with Sickle cell crises. It is important that care providers, especially in populations with high burden of Sickle Cell Anaemia, consider this as a differential diagnosis, especially when the jaundice is associated with profound or recurring episodes of hypoglycaemia. Prompt diagnosis and delivery in a multidisciplinary approach is important to avoid adverse maternal and foetal outcomes.
Keywords: Vaso-occlusive crises, acute fatty liver of pregnancy, hypoglycaemia, Sickle-cell anaemia
Funding: No funding sources

Published
2020-09-30
Section
Articles

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print ISSN: 0016-9560