"...At this point I do not see any reason to suspect that this is related to HELLP..."

Q:  I had my first child on November 13, 2002.  I was diagnosed with HELLP Syndrome pretty much at the same time the baby was delivered by C-section at 34 weeks gestational. 

I started to have this current problem the weekend before Christmas.  It began with ringing in my ears.  Now I have this persistent sound of blood pounding in my right ear.  My primary care physicians thought it was a simple ear infection but last night I had an MRI with gadolinium contrast. The findings are "suspicious for an infiltrative process, i.e. neoplasm, myeloproliferative disorder, or replacement or red marrow secondary to anemia."  My blood count was over 200,000 when I was admitted into the hospital, dropped to 112,000 when I delivered my son two days later, and dropped by nightfall to 80,000.  I was told I was extremely lucky and was very close to bleeding uncontrollably.

I am trying to find out any information indicative of lasting blood problems given my current situation.  I am not even sure which type of doctor I need to see for the best care possible.  I am currently under the care of an ENT doctor but am wondering if this is correct.

I am at a loss as to which way to go.  My ENT hadn't even heard of HELLP Syndrome.


A:  I am assuming that the blood count you refer to is your platelet count.  You had a fall from 200,000 to 80,000.  This is certainly serious but not uncommon with HELLP.  Most women at 80,000 do not bleed to death.  If they need cesarean, platelets can be replaced.  More seriously, if her hypertension is not controlled well and she begins to develop bleeding into the brain, a low platelet count will make it much worse.

I am not at all sure how to interpret the MRI. I assume that it was of your head, near your ear.  Things like an infiltrative process, i.e. neoplasm, myeloproliferative disorder, or replacement or red marrow secondary to anemia are usually cared for by a hematologist-oncologist.

At this point I do not see any reason to suspect that this is related to HELLP.  It is possible that this finding will lead to the diagnosis of an inflammatory condition like lupus.  In that case, sub clinical lupus in 2002 may have contributed to the development of HELLP.  HELLP would not have directly caused your current problem.