[ case report of successful treatment of hellp syndrome and thrombotic thrombocytopenic purpura by plasmapheresis]

HELLP syndrome was described in 1982 by Weinstein as a triad of hemolysis, elevated liver enzymes and thrombocytopenia. This syndrome develops antepartum in 70% and postpartum in 30% of cases. HELLP syndrome occurs in 0.5 to 0.9% of all pregnancies and is accompanied by disseminated intravascular coagulation [DIC] in 38% of patients. Maternal mortality rate is reported to be 1.1%. Although thrombotic thrombocytopenic purpura [TTP] is rare, it is one of the most important differential diagnoses for HELLP syndrome, which may be lethal without appropriate treatment. Plasmapheresis is one of the recommended treatments in complicated and/or resistant to treatment cases. In this article we introduce a 22 years old primiparous woman with a term pregnancy that developed HELLP syndrome and DIC after delivery. Due to the lack of improvement, an accompany of TTP was diagnosed. So, she underwent plasmapheresis treatment and was discharged with full recovery after 22 sessions of treatments

[ abdominal mass due to trichobezoare in a 14- year old girl]

Gastric bezoars results from the accumulation of foreign ingested materials in the form of masses or concretions. Bezoars are rare and being found in less than 0.5 percent of patients undergoing upper gastrointestinal endoscopies. Bezoars are classified according to their composition. The major types of bezoars are phytobezoars, trichobezoars and pharmacobezoars. Trichobezoars are typically seen in the women in their 20s. Patients with bezoar remain asymptomatic for many years and develop symptoms insidiously. Common complaints include abdominal pain, nausea, vomiting, early satiety, anorexia and weight loss. Bezoars have rarely been associated with other gastrointestinal complications such as gastric outlet obstruction [GOO], intestinal obstruction, gastrointestinal bleeding, gastrointestinal perforation, necrotizing pancreatitis, obstructive jaundice, hypochromic anemia, B12 deficiency and abdominal mass. In our case thrichobezoare manifested with an abdominal mass and hypochromic anemia