Postpartum Page Kidney Secondary to HELLP Syndrome

Abstract

Page Kidney is a unique clinical entity causing hypertension secondary to external renal compression. We report the case of a female patient who was antenatally diagnosed to have HELLP syndrome and subsequently developed a spontaneous subcapsular haematoma causing Page kidney that was promptly diagnosed and managed in the postpartum period. A 30-year-old female patient presented to the emergency department with chief complains of pain in the right lumbar region and intermittent high grade fever since 10 days. Patient was 20 days post-partum and presented with hypertension. An ultrasound of the abdomen and CECT abdomen was done to evaluate the cause for tenderness and to our surprise there was a subcapsular haematoma measuring 8×5×3 cm compressing the right kidney. An open exploration for evacuation of haematoma was done. Acute kidney injury with HELLP syndrome is a known entity however; renal subcapsular haematoma secondary to low platelets is a rare finding. A high index of suspicion is essential to timely diagnose Page kidney. Page kidney as mentioned in previous literature and as observed in this case report is a reversible cause of hypertension and a low threshold for capsulotomy and drainage of the haematoma with optimal post-operative management of this condition would prevent long term sequela of hypertension among young patients.

Keywords

• acute kidney injury
• haematoma
• hypertension