{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T14:00:10Z","timestamp":1764165610688,"version":"3.46.0"},"reference-count":12,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Obstet Med"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This report details the complexities of diagnosing and treating rapid-onset multisystemic hemophagocytic lymphohistiocytosis (HLH) during pregnancy, as evidenced by a fatal case in early pregnancy with severe hematological and obstetric complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 20-year-old pregnant woman in her second pregnancy presented at 8 weeks of gestation with abdominal pain, fever, and rectal bleeding. Laboratory tests revealed leukopenia, thrombocytopenia, and anemia, leading to immediate transfusion and intensive care unit admission. Despite intensive interventions, including vasopressors and antibiotics, the patient developed progressive organ failure, with disseminated intravascular coagulation, and suffered a fatal stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This critical case with severe complications demonstrates the diagnostic and treatment challenges of rapid-onset HLH in early pregnancy. Early and accurate differential diagnosis in obstetric emergencies is vital for conditions such as HLH. This case highlights the importance of multifaceted care in managing pregnant patients with complex, atypical presentations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1753495x251314168","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T03:36:29Z","timestamp":1737689789000},"page":"260-263","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Hemophagocytic lymphohistiocytosis in early pregnancy: A rare and fatal diagnostic challenge"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0310-3235","authenticated-orcid":false,"given":"Jose","family":"Rojas-Suarez","sequence":"first","affiliation":[{"name":"Universidad de Cartagena"},{"name":"Corporaci\u00f3n Universitaria Rafael N\u00fa\u00f1ez"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Ramos","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Department, Hospital Municipal Villa primero de Mayo, Santa Cruz de la Sierra, Bolivia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Lazarte","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Department, Hospital Municipal Villa primero de Mayo, Santa Cruz de la Sierra, Bolivia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofia","family":"Cifuentes","sequence":"additional","affiliation":[{"name":"Universidad Sim\u00f3n Bol\u00edvar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Leon","sequence":"additional","affiliation":[{"name":"Universidad Sim\u00f3n Bol\u00edvar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendy","family":"Casta\u00f1eda","sequence":"additional","affiliation":[{"name":"Universidad Sim\u00f3n Bol\u00edvar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Morales","sequence":"additional","affiliation":[{"name":"Universidad de Cartagena"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasaira","family":"Pajaro","sequence":"additional","affiliation":[{"name":"Universidad de Cartagena"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmelo","family":"Due\u00f1as-Castell","sequence":"additional","affiliation":[{"name":"Universidad de Cartagena"},{"name":"Intensive Care Department, Gesti\u00f3n Salud Clinic, Cartagena, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"key":"e_1_3_3_2_2","article-title":"Fever, cough, and gastrointestinal symptoms in a pregnant woman","volume":"21","author":"Jha N","year":"2021","unstructured":"Jha N, Balachandran DM, Jha AK. Fever, cough, and gastrointestinal symptoms in a pregnant woman. Clin Med Lond Engl 2021; 21: e526\u2013e528.","journal-title":"Clin Med Lond Engl"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13023-021-01790-9"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-023-06664-y"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000005361"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.38690"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqw076"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2018-224832"},{"key":"e_1_3_3_9_2","first-page":"752","article-title":"Immunomodulatory effects of vasoactive catecholamines","volume":"114","author":"Bergmann M","year":"2002","unstructured":"Bergmann M, Sautner T. Immunomodulatory effects of vasoactive catecholamines. Wien Klin Wochenschr 2002; 114: 752\u2013761.","journal-title":"Wien Klin Wochenschr"},{"key":"e_1_3_3_10_2","first-page":"2124856","article-title":"Hemophagocytic syndrome during pregnancy: a case report and literature review","volume":"43","author":"Liu X","year":"2023","unstructured":"Liu X, Yu H, Li G, et al. Hemophagocytic syndrome during pregnancy: a case report and literature review. J Obstet Gynecol J Inst Obstet Gynecol 2023; 43: 2124856.","journal-title":"J Obstet Gynecol J Inst Obstet Gynecol"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.138.9.1208"},{"key":"e_1_3_3_12_2","article-title":"Hemophagocytic lymphohistiocytosis in pregnancy","volume":"7","author":"Jawad S","year":"2020","unstructured":"Jawad S, Dhariwal A, Ellis L, et al. Hemophagocytic lymphohistiocytosis in pregnancy. 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Cureus 2024; 16: e53841.","journal-title":"Cureus"}],"container-title":["Obstetric Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1753495X251314168","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1753495X251314168","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1753495X251314168","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T13:55:51Z","timestamp":1764165351000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1753495X251314168"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,24]]},"references-count":12,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1177\/1753495X251314168"],"URL":"https:\/\/doi.org\/10.1177\/1753495x251314168","relation":{},"ISSN":["1753-495X","1753-4968"],"issn-type":[{"type":"print","value":"1753-495X"},{"type":"electronic","value":"1753-4968"}],"subject":[],"published":{"date-parts":[[2025,1,24]]}}}