CASE REPORT article
Front. Med.
Sec. Obstetrics and Gynecology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1641271
Case Report: A Rare Complication of Non-Hypertensive HELLP Syndrome — Microangiopathic Coagulation Activation Leading to Postpartum DIC with Acute Kidney Injury
Provisionally accepted
- 1Sichuan Jinxin Xinan Women and Children's Hospital, Chengdu, China
- 218284535909, chengdu, China
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Thrombotic Disseminated intravascular coagulation (DIC) associated with Hemolysis, elevated liver Enzymes, and low platelets (HELLP) syndrome in the absence of typical hypertension is rare, and its pathogenesis differs significantly from that of hemorrhagic DIC. Although the overall incidence is low, disease progression is often rapid and carries a high risk of multi-organ failure. Pregnancy-specific physiologic changes, including endothelial injury, hypercoagulability, and a predisposition to microcirculatory thrombosis, markedly increase the likelihood of microangiopathic coagulation activation in non-hypertensive HELLP patients. Therefore, prompt recognition of coagulation abnormalities and timely, targeted interventions are crucial for improving patient outcomes. Here, we report a case of HELLP syndrome without prenatal hypertension that rapidly progressed to DIC and acute kidney injury (AKI), despite only moderate blood loss (800 mL). This case highlights potential mechanisms underlying microangiopathic coagulation activation and provides an important reference for the clinical recognition and management of such occult coagulopathies.
Keywords: HELLP Syndrome, Disseminated Intravascular Coagulation, thrombotic microangiopathy, Acute Kidney Injury, Fluid Therapy, obstetric coagulation disorders, case report
Received: 04 Jun 2025; Accepted: 25 Sep 2025.
Copyright: © 2025 Li, Tang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yong Tang, 1960544843@qq.com
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