Differential Diagnosis
- Single most likely diagnosis
- HELLP syndrome: This condition is characterized by Hemolysis, Elevated Liver enzymes, and Low Platelet count. The patient's symptoms, such as right upper quadrant pain, scleral icterus, and elevated liver enzymes, along with a low platelet count, are consistent with HELLP syndrome. The patient's hemoglobin level is also slightly low, which could indicate hemolysis.
- Other Likely diagnoses
- Acute cholecystitis: The patient's right upper quadrant pain and tenderness to palpation could suggest acute cholecystitis. However, the absence of rebound or guarding and the presence of scleral icterus make this diagnosis less likely.
- Acute viral hepatitis: The patient's elevated liver enzymes and bilirubin levels could indicate acute viral hepatitis. However, the patient's symptoms and laboratory results are more consistent with a pregnancy-related condition.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pulmonary embolism: Although the patient's symptoms do not strongly suggest pulmonary embolism, it is a potentially life-threatening condition that should be considered in any pregnant patient with sudden onset of pain and respiratory symptoms.
- Appendicitis: Although the patient's pain is in the right upper quadrant, appendicitis can present atypically in pregnant patients, and a missed diagnosis could be catastrophic.
- Rare diagnoses
- Budd-Chiari syndrome: This rare condition, characterized by hepatic vein thrombosis, could present with similar symptoms, such as abdominal pain and liver dysfunction. However, it is much less common than other conditions on this list.
- Wilson's disease: This rare genetic disorder can cause liver dysfunction and hemolysis, but it is unlikely in this patient given the acute onset of symptoms and the patient's age.