Double heterozygosis HbC/p-thal is a rare condition that causes hypochromic microcytic and hemolytic anémia, mild jaundice, and mild splenomegaly....Our case seems to indicate that the patient's pregnancy suddenly worsened preexisting hypochromic microcytic anemia and triggered red blood cell hemolysis. On the basis of the autopsy, laboratory, and anamnestic data, we offer the following tentative explanation of her clinical history.
The β-thalassemic trait and unstable HbC were responsible for her well-compensated anemic status, but the hemolytic anemia was suddenly worsened by pregnancy and triggered massive extramedullary hematopoiesis, giving rise to splenomegaly and finally, splenic rupture with massive intraperitoneal hemorrhage and death.