A 24 year old Korean pregnant woman in 33 weeks gestation (gravida 2, para 0) was
admitted to Ewha Womans University Hospital with the chief complains of weakness,
headache, dizziness, nausea, edema, oliguria and progressive soreness of mouth of one
month duration.
Physical examination and laboratory findings showed marked pitting edema,
proteinuria, (++ ∼ +++) hypertension (150/100-170/130mmHg), severe anemia (5.7gm/dl).
Other laboratory examination revealed total protein: 5.59m/dl (albumin 2.6, globulin 2.9),
alkaline phosphatase: 12.6 B. U., S-GOT: 38 units, CO2 combining power:
49 vol.%.
Megaloblastic nucleated red cells appeared in the peripheral smears and typical
megaloblastic changes were seen in the bone marrow smears.
During the hospital admission, she delivered a still-born baby with no gross
abnormalities.
A characteristic reticulocyte response was observed with folic acid administration and
the clinical manifestations were relieved rapidly with the termination of pergnancy and
the folic acid therapy.
The bole marrow examination after five months since her discharge from the hospital
revealed a normoblastic marrow with mild iron deficiency pattern.
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