CASE PRESENTATION:
Gestational diabetes mellitus is associated with increased risk of breast and
pancreatic cancer. This case report describes a 29-year-old Chinese woman who presented with:
gestational diabetes mellitus; International Society on
Thrombosis and Haemostasis criteria suggested
disseminated intravascular coagulation with a score of 5;
hemolysis, elevated liver
enzymes, low platelet count syndrome; and
pulmonary hypertension. After an
intravenous injection of
fibrinogen, she gave birth to a normal baby and following delivery, her blood pressure reached 180/110 mmHg. Laboratory analysis results showed elevated lactic
dehydrogenase, decreased platelets and
fibrinogen, and urine
protein was positive. She was transfused with fresh frozen plasma,
blood coagulation factor, and
fibrinogen. Subsequently, she was transferred to a maternity intensive care unit, where
magnesium sulfate seizure prophylaxis was continued for 24 hours to keep her
magnesium level at a low therapeutic range. However, continuous
oxygen therapy was needed to maintain her oxygenation. Further laboratory investigations revealed elevated
carcinoembryonic antigen,
carbohydrate antigen 19-9, and
carbohydrate antigen 72-4. Positron emission tomography-computed tomography showed malignant
carcinoma in the head of her pancreas with lymph node involvement along with bone, peritoneal, and left adrenal
metastasis, as well as double lung lymphangitic
carcinomatosis.
CONCLUSION: