Abstract

FERREIRA, Melanie et al. Chronic Histiocytic Intervillositis: A Rare Cause of Placenta Mediated Obstetrical Events Associated with Isolated Alkaline Phosphatase Elevation?. Medicina Interna [online]. 2017, vol.24, n.4, pp.296-299. ISSN 0872-671X.  https://doi.org/10.24950/rspmi/CC25/16/2017.

The authors report a case of a 31-year-old woman, pregnant for the third time, with a medical history of severe placental mediated obstetrical complications, referred for exclusion of a pro-thrombotic state. Thrombophilia testing was negative, however isolated alkaline phosphates elevation (10 times superior to the upper reference limit) was detected. Alkaline phosphatase elevation that does not surpass twice the upper reference limit during the third trimester of pregnancy is considered normal. Elevation beyond those levels requires differential diagnosis with liver, bone and renal disease. Off-label anti-thrombotic therapy was offered during the entire pregnancy, which carried on. The patient gave birth to a healthy baby. Evaluation of the placenta revealed chronic histiocytic intervillositis, a rare pathology yet to be fully understood, linked to autoimmune placental phenomena and elevated alkaline phosphatase.

Keywords : Alkaline Phosphatase; Chorionic Villi; Histiocytes; Placenta Diseases; Pregnancy Complications.

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