A life-saving therapy in Class I HELLP syndrome: Therapeutic plasma exchange

Erkurt, Mehmet Ali; Berber, İlhami; Berktas, Haci Bayram; Kuku, İrfan; Kaya, Emin; Köroğlu, Mustafa; Nizam, Ilknur; Bakırhan, Fatma Acar; Özgül, Mustafa

doi:10.1016/j.transci.2014.12.026

Cited by 33 publications

(34 citation statements)

References 30 publications

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“…It is characterized by microangiopathic hemolytic anemia, elevation of liver enzymes, and thrombocytopenia [135]. The severity can be assessed by platelet counts (severe 50 k/μl, moderate 100 k/μl, and mild 150 k/μl) [1].…”

Section: Short Description and Symptomsmentioning

confidence: 99%

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Immunology of hepatic diseases during pregnancy

2016

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The mother's immune system has to adapt to pregnancy accepting the semi-allograft fetus and preventing harmful effects to the developing child. Aberrations in feto-maternal immune adaptation may result in disease of the mother, such as liver injury. Five pregnancy-associated liver disorders have been described so far, however, little is known concerning immune alterations promoting the respective disease. These liver disorders are pre-eclampsia, hemolysis, elevated liver enzymes, low platelet count (HELLP), acute fatty liver, hyperemesis gravidarum, and intrahepatic cholestasis of pregnancy. On the other hand, pre-existing autoimmune liver injury of the mother can be affected by pregnancy. This review intends to summarize current knowledge linking feto-maternal immunology and liver inflammation with a special emphasis on novel potential biomarkers.

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Section: Short Description and Symptomsmentioning

confidence: 99%

“…A neonatal intensive care unit should be accessible. During severe HELLP, women unresponsive to e.g., anti-hypertensive therapy might need a postpartum therapeutic plasma exchange to support liver functions and reduce the inflammatory burden [135].…”

Section: Therapymentioning

confidence: 99%

Immunology of hepatic diseases during pregnancy

2016

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“…The effectiveness of dexamethasone is not clearly defined [14]. However, some research demonstrated that postpartum plasma exchange therapy improves treatment outcomes in patients with severe HELLP syndrome [11,[15][16][17]. Patients who do not show improvement of platlets and ASAT levels within the first 24 to 48 hours after delivery and patients with renal or neurological involvement may have benefit from plasma-exchange between 24 and 72 hours postpartum as shown by Simetka et al [18].…”

Section: Discussionmentioning

confidence: 99%

The Use of Plasma Exchange in a Very Early-onset and Life Threatening, Hemolysis, Elevated Liver Enzymes, and Low Platelet (HELLP) Syndrome: A Case Report

Iannaccone¹,

Tyczynski²

2016

Gynecol Obstet

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Background: HELLP syndrome is a life threatening pregnancy and early postpartum complication. Very early presentation (before the 21st pregnancy week) is rare and represents an extremely difficult situation for patients and physicians. Supportive therapy (magnesium sulfate, antihypertensive drugs and corticosteroids) may be useful to prolong pregnancy; till now the removing of placenta is the only effective therapeutic option. Plasmapheresis may represent a new and efficacious therapeutic option.

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“…Several centers used high‐dose corticosteroids as part of the treatment plan; however, corticosteroids did not reduce risk of maternal death, maternal morbidity, or perinatal death . In patients whose symptoms do not resolve within 72 h after delivery, TPE may be attempted to remove circulating protein bound platelet (PLT) aggregating and pro‐coagulant factors released from both activated PLTs and endothelial cells . TPE has been reported to be clinically beneficial in both improving PLT count and decreasing LDH and AST levels .…”

Section: New Diseases – Category IIImentioning

confidence: 99%

Critical updates in the 7^th edition of the American Society for Apheresis guidelines

Ipe

Pham

Williams

2017

J of Clinical Apheresis

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The 7 th edition of the American Society for Apheresis (ASFA) guidelines was composed by an international physicians committee, and includes 14 new diseases, and 2 new indications for diseases described in the former guidelines. Several indications have either changed names or were excluded from this edition. The guidelines are developed after taking into account documented evidence, either supporting or negating use of apheresis technology in the treatment of diseases. Based on this evidence, the committee revises, updates and includes or excludes disease entities/indications in the guidelines. This article describes the revisions to the 7 th edition of the ASFA guidelines, in a comprehensive manner. K E Y W O R D Sapheresis, ASFA guidelines, critical updates, diseases and indications, 7th edition

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A life-saving therapy in Class I HELLP syndrome: Therapeutic plasma exchange

Cited by 33 publications

References 30 publications

Immunology of hepatic diseases during pregnancy

Immunology of hepatic diseases during pregnancy

The Use of Plasma Exchange in a Very Early-onset and Life Threatening, Hemolysis, Elevated Liver Enzymes, and Low Platelet (HELLP) Syndrome: A Case Report

Critical updates in the 7^th edition of the American Society for Apheresis guidelines

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A life-saving therapy in Class I HELLP syndrome: Therapeutic plasma exchange

Cited by 33 publications

References 30 publications

Immunology of hepatic diseases during pregnancy

Immunology of hepatic diseases during pregnancy

The Use of Plasma Exchange in a Very Early-onset and Life Threatening, Hemolysis, Elevated Liver Enzymes, and Low Platelet (HELLP) Syndrome: A Case Report

Critical updates in the 7th edition of the American Society for Apheresis guidelines

Contact Info

Product

Resources

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Critical updates in the 7^th edition of the American Society for Apheresis guidelines