Hemolysis, Elevated Liver Enzymes and Low Platelet (HELLP) Syndrome Associated with Systemic Lupus Erythematosus

Matsuda, Masayuki; Mitsuhashi, Shigeaki; Watarai, Megumi; Yamamoto, Kanji; Hashimoto, Takao; Ikeda, Shu‐ichi

doi:10.2169/internalmedicine.42.1052

Cited by 7 publications

(5 citation statements)

References 6 publications

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“…The diagnosis of the complete form is based on the presence of all 3 major components, but incomplete forms can be presented with only 1 or 2 components of the complete triad (4). The HELLP in its complete form is a serious condition and is associated with substantial risk for the mother and her foetus (5,6). The minor fraction of HELLP is caused by the foetal homozygous LCHAD (Long-chain 3-hydroxyacyl-CoA dehydrogenase defi ciency), but for the most cases, the genetic background has not yet been elucidated (7).…”

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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“…HELLP syndrome is a serious condition in its complete form and associated with maternal and fetal risks. [78]…”

Section: Introductionmentioning

confidence: 99%

Abdelazim and AbuFaza ELLP syndrome as a variant of HELLP syndrome: Case reports

Abdelazim

Abu-Faza²

2019

J Family Med Prim Care

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Background: The hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome is a serious complication in pregnancy occurring in 0.5–0.9% of all pregnancies and in 10–20% of cases with severe pre-eclampsia. Previous studies described HELLP syndrome without hemolysis without any further details. Objectives: This report represents the criteria for the diagnosis of Abdelazim and AbuFaza elevated liver enzymes, low platelet count (ELLP) syndrome as a variant of HELLP syndrome. Case Reports: A 39-year-old woman, pregnant 32 weeks’ gestation, previous five cesarean sections, admitted with severe pre-eclampsia (blood pressure 160/110 mmHg, proteinuria +3, 700 mg proteins/24 h urine, and protein/creatinine ratio ≥0.9 in spot urine sample). Laboratory investigation showed elevated liver enzymes, low platelet (PLT) count, and no evidence of hemolysis. A 31-year-old woman, pregnant 33 +4 weeks’ gestation, previous one cesarean section, admitted with severe pre-eclampsia (blood pressure 170/120 mmHg, proteinuria +2, 1200 mg proteins/24 h urine, and protein/creatinine ratio 1.1 in spot urine sample). Laboratory investigations showed elevated liver enzymes, low PLT count, and no evidence of hemolysis. Both patients delivered by cesarean section after stabilization of their blood pressure and dexamethasone for induction of fetal lung maturity and MgSO 4 for prevention of eclampsia. Both patients had uneventful intraoperative and postoperative stay in the hospital. The liver enzymes and the PLT count were completely normal on the 5 th postoperative day, and they were discharged from the hospital in good general condition. Conclusion: Abdelazim and AbuFaza ELLP syndrome is variant of HELLP syndrome without hemolysis in women with severe pre-eclampsia. Abdelazim and AbuFaza ELLP syndrome diagnostic criteria are as follows: (1) Elevated liver enzymes; (2) Low PLT count; and (3) Absence of hemolysis (normal total and unconjugated bilirubin, absence of schizocytes, and polychromatic red cells in peripheral blood smear, and normal reticulocyte count).

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“…HELLP cиндром -небезпечне для життя ускладнення вагітності, яке виникає на пізніх термінах вагітності або іноді після пологів та асоційоване зі значним ризиком смертності як матері, так і плоду [3][4][5][6][7][8][9][10]. Симптоми, як правило, розвиваються між 28 та 36 тижнями гестації, але описані випадки розвитку захворювання у другому триместрі вагітності або після пологів [9,10].…”

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“…Діагностика повної форми HELLP синдрому вимагає наявності всіх 3 основних компонентів, тоді як частковий або неповний HELLP синдром складається лише з 1 або 2 елементів тріади (Н або ЕP або LP) [3,7,8,12]. Середній вік вагітних з HELLP синдромом зазвичай вищий, ніж у жінок з гестозом [3,14].…”

unclassified

“…Найбільш високий ризик розвитку HELLP синдрому мають вагітні, в анамнезі яких спостерігались прееклампсія, гіпертензія, прегестаційний діабет, багатоплідна вагітність, хронічні захворювання нирок та деякі аутоімунні захворювання (антифосфоліпідний синдром, системний червоний вовчак) [9]. Продемонстровано, що за наявності ХХН відносний ризик розвитку HELLP синдрому збільшується майже вдвічі (RR 1,8, 95% ІС 1,5-2,1) [7,11]. Але залишається нез'ясованим питання: чому перша вагітність вважається важливим фак-тором схильності до гестозу (RR 2.1, 95% ДІ 1.9-2.4) [8,11], який може ускладнюватись HELLP синдромом?…”

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HELLP syndrome against the background of glomerulonephritis: Clinical casereport

Lebid

Snisar

Liksunova

2019

Ukr. J. Nephrol. and Dial.

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HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) is a severe and rapidly progressing condition that requires distinct diagnostic considerations. The clinical presentation varied within all of the classes, and the only objective means of diagnosis and evaluation of progression of the condition are laboratory tests. HELLP syndrome may result in severe morbidity and mortality to both the mother and fetus. In this case, we reported that a patient with chronic glomerulonephritis was diagnosed with HELLP syndrome.The case was collected in Institute of Nephrology of the National Academy of Medical Sciences, Kyiv, Ukraine.

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Hemolysis, Elevated Liver Enzymes and Low Platelet (HELLP) Syndrome Associated with Systemic Lupus Erythematosus

Cited by 7 publications

References 6 publications

Postpartum corticosteroids in HELLP syndrome – standard to prompt recovery

Postpartum corticosteroids in HELLP syndrome – standard to prompt recovery

Abdelazim and AbuFaza ELLP syndrome as a variant of HELLP syndrome: Case reports

HELLP syndrome against the background of glomerulonephritis: Clinical casereport

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