A Case of HELLP Syndrome with Multiple Complications

Iwashita, Yoshiaki; Kan’o, Tomomichi; Hattori, J; Konno, Shingo; Imai, Hiroshi; Kitahara, Takao; Soma, Kazui

doi:10.2169/internalmedicine.51.7715

Cited by 4 publications

(2 citation statements)

References 14 publications

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“…The reported cases of the postpartum HELLP are also called "the cases of lost battles". Because of unexpectedness, suddenness and fulminant course and as well for absence of the clinical signs of preeclampsia, this syndrome can lightly confuse the physicians and obstetricians and can lead to diagnostic delay (10) Although variable, the typical onset of the syndrome is rapid (11). The majority of the diagnosed cases were preceded by preeclampsia, hypertension, proteinuria, excessive weight gain or generalized oedema (12).…”

Section: Pathogenesis and Diagnosis Of The Hellpmentioning

confidence: 99%

Postpartum corticosteroids in HELLP syndrome – standard to prompt recovery

Gábor¹,

Drab²,

Holomán³

2016

BLL

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OBJECTIVES: To perform a complex review of HELLP syndrome and its treatment from up to date scientifi c literature. Study of the interresting treatement regime of the patient. METHODS: Complex analysis of the syndrome, systematic search of medical scientifi c databases and Slovak Medical Library. Analysis of the life threatening state of the patient, retrospective analysis of the diagnostics, treatment, acute management, complications and clinical results. RESULTS: According to up to date literature and our good clinical experiences we can encourage the use of high-dose corticosteroid therapy in HELLP syndrome. CONCLUSION: The most recent studies defi nitely recommend the high dose corticosteroid treatment in recovery management by the HELLP syndrome. We have used the high-dose corticosteroid regime as a recovery management for the patient with postpartum HELLP with very good clinical and laboratory response followed by prompt recovery of the patient and without other complications. We want to support and empasize the indication of the Dexamethasone regiment by HELLP, becouse the clinical experiences with this treatment are not well-known and usually the corticosteroids are not given to the patients with HELLP, or the treatment is "daemonized". Our clinical experience with this treatment was successful and the patient defi nitely profi ted of it. We support the opinion, that the benefi t of described regiment highly exceedes the possible adverse effects of the therapy (Fig. 8, Ref. 61). Text in PDF www.elis.sk.

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Section: Pathogenesis and Diagnosis Of The Hellpmentioning

confidence: 99%

Postpartum corticosteroids in HELLP syndrome – standard to prompt recovery

Gábor¹,

Drab²,

Holomán³

2016

BLL

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“…In addition to this, increased activation of the coagulation system is proposed to play a contributing role in the cause of intracerebral hemorrhage and the increased concentrations of oxyhemoglobin derived from hemolysis and thrombocytopenia in patients with HELLP might exaggerate this vascular response. 4,5 As the name suggests, there is a predisposition to vasogenic edema in PRES for the posterior white matter, because the anterior cerebral circulation has higher sympathetic innervations than the vertebrobasilar system, which is protective against damaging hypertension. 1 Two types of PRES have been described: classical and variant.…”

Section: Case Studymentioning

confidence: 99%

Brain MRI findings of a 24-week pregnant woman with HELLP syndrome

Beker‐Acay

Ünlü

Okur

et al. 2016

Polish Annals of Medicine

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Available online xxxKeywords: Eclampsia Hypertensive encephalopathy Magnetic resonance imaging a b s t r a c t Introduction: HELLP syndrome (acronym comprised of hemolysis, elevated liver enzymes and low platelets) is seen in 0.1% of pregnant women. Posterior reversible encephalopathy syndrome (PRES) was reported to be 5% in patients with the HELLP syndrome. Atypical imaging appearances include contrast enhancement, hemorrhage and restricted diffusion on MRI.Aim: We aimed to improve clinicians' perception about brain lesions in the HELLP syndrome with imaging findings.Case study: Here, we present a case of an 18-year-old patient with a pregnancy of 24 weeks admitted with HELLP syndrome, with CT and MRI findings of PRES and intracerebral hematoma. MRI scan of the brain showed vasogenic edema in the occipital, frontal and parietal lobes bilaterally, basal ganglia and brainstem. An emergency cesarean section was successfully performed to end the pregnancy on the same day. Repeat MRI of the brain three days after initial admission showed partial improvement of the previous abnormalities with full clinical recovery.Results and discussion: The patient in this report had a variant form of PRES where the pathologic process encompassed both the posterior and anterior circulations.Conclusions: An appropriate multidisciplinary approach is the key for reducing the morbidity and mortality of PRES syndrome.

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