October 18th, 2018

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Full Blown Eclampsia and HELLP Syndrome in a Case with Placental Mesenchymal Dysplasia: A Case Report
Authors:  Emre Zafer, M.D., Sumeyra Nergiz Avcioglu, M.D., Kanay Yanarbas, M.D., and Canten Tataroglu, M.D.
BACKGROUND: Placental mesenchymal dysplasia (PMD) is a rare clinical diagnosis that can challenge clinicians.

CASE: We discuss a PMD case with eclampsia/HELLP syndrome at 29 weeks of gestation, with delivery of a liveborn infant. Quantitative fluorescence PCR (QF-PCR) analysis of the cystic placenta along with parental blood samples revealed monoallelic androgenetic structure. Placental pathology was consistent with PMD. Fetal karyotype was 46,XY. PMD reports are rare, and this case is particularly unusual due to its presentation with eclampsia/HELLP, markedly elevated human chorionic gonadotropin (hCG) levels, and a male karyotype.

CONCLUSION: A cystic placenta and elevated hCG without accompanying fetal anomalies should be interpreted cautiously. Short tandem repeat marker analysis for delineating allelic structure can help in the differential diagnosis.
Keywords:  cystic placenta, eclampsia, genetic markers, HELLP, HELLP syndrome, placenta diseases, placental mesenchymal dysplasia, STR marker analysis, short tandem repeats
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