Hepatic and splenic haemorrhage as a complication of toxaemia of pregnancy in a patient with circulating lupus anticoagulant.

A 29 year old pregnant woman presented at 28 weeks with severe upper abdominal pain. Features of pre-eclamptic toxaemia became apparent and intrauterine death occurred abruptly. The development of shock, a reduction in haemoglobin from 124 to 88 g/l without evidence of external blood loss and tender hepatosplenomegaly suggested major intrahepatic and intrasplenic haemorrhage. This suggestion was supported by ultrasound and CT scans. The patient made a complete recovery over a period of weeks. She was shown to have a circulating LE-inhibitor and had major thrombotic episodes involving her leg veins.