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https://www.readbyqxmd.com/read/27868334/consensus-on-the-standardization-of-terminology-in-thrombotic-thrombocytopenic-purpura-and-related-thrombotic-microangiopathies
#1
M Scully, S Cataland, P Coppo, J de la Rubia, K D Friedman, J Kremer Hovinga, B Lämmle, M Matsumoto, K Pavenski, E Sadler, R Sarode, H Wu
BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS) are two important acute conditions to diagnose. Thrombotic Microangiopathy is a broad pathophysiological process that leads to microangiopathic hemolytic anemia, thrombocytopenia and involves capillary and small vessel platelet aggregates. The most common cause being disseminated intravascular coagulation (DIC), which may be differentiated by abnormal coagulation. Clinically, a number of conditions present with microangiopathic hemolytic anemia and thrombocytopenia (MAHAT), including cancer, infection, transplantation, drugs, autoimmune disease and pre-eclampsia and HELLP (Hemolysis, Elevated Liver enzymes, Low Platelet count) syndrome in pregnancy...
November 21, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27854396/maternal-cardiac-function-after-hellp-syndrome-an-echocardiographic-study
#2
Rossana Orabona, Enrico Vizzardi, Edoardo Sciatti, Federico Prefumo, Ivano Bonadei, Adriana Valcamonico, Marco Metra, Tiziana Frusca
OBJECTIVES: To evaluate maternal hemodynamics in asymptomatic women with a pregnancy complicated by hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, and compare it with patients with a previous preeclampsia (PE) and controls with uncomplicated pregnancies. METHODS: Women with a history of PE (n = 60) or HELLP syndrome (n = 49) and matched healthy controls (n = 60) underwent an echocardiographic examination 6 months-4 years after delivery, recording left ventricular (LV) dimensions, ejection fraction (LVEF) and mass, right ventricular (RV) tricuspid annular plane systolic movement (TAPSE) and fractional area changing (FAC)...
November 10, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27848226/atypical-hemolytic-uremic-syndrome-in-the-setting-of-complement-amplifying-conditions-case-reports-and-a-review-of-the-evidence-for-treatment-with-eculizumab
#3
REVIEW
Arif Asif, Ali Nayer, Christian S Haas
Atypical hemolytic uremic syndrome (aHUS) is a rare, genetic, progressive, life-threatening form of thrombotic microangiopathy (TMA) predominantly caused by dysregulation of the alternative pathway of the complement system. Complement-amplifying conditions (CACs), including pregnancy complications [preeclampsia, HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome], malignant hypertension, autoimmune diseases, transplantation, and others, are associated with the onset of TMA in up to 69 % of cases of aHUS...
November 15, 2016: Journal of Nephrology
https://www.readbyqxmd.com/read/27800247/bilateral-vision-loss-after-delivery-in-two-cases-severe-preeclampsia-and-hellp-syndrome
#4
Gökhan Çelik, Ahmet Eser, Murat Günay, Nursal Melda Yenerel
Two patients with no symptoms of hypertension in their medical history before pregnancy were referred to the obstetrics emergency clinic with hypertension and visual complaints. After physical examination and laboratory tests, one of the patients was diagnosed with severe preeclampsia while the other was diagnosed with HELLP syndrome (Hemolysis-Elevated Liver enzymes-Low Platelets). Ocular examinations were performed after delivery due to the patients' worsening visual complaints. The severe preeclamptic patient showed bilateral serous retinal detachment (SRD) while the patient with HELLP syndrome showed bilateral macular hemorrhage...
December 2015: Turkish Journal of Ophthalmology
https://www.readbyqxmd.com/read/27793243/anesthesia-in-pregnant-women-with-hellp-syndrome-case-report
#5
Eduardo Barbin Zuccolotto, Eugenio Pagnussatt Neto, Glínia Cavalcante Nogueira, José Roberto Nociti
BACKGROUND AND OBJECTIVES: HELLP syndrome, characterized by hemolysis, high levels of liver enzyme, and low platelet count, is an advanced clinical stage of pre-eclampsia, progressing to high maternal (24%) and perinatal (up 40%) mortality, despite childbirth care in a timely manner. The goal is to describe the anesthetic management of a case with indication to emergency cesarean. CASE REPORT: Female patient, 36 years old, gestational age of 24 weeks, with hypertensive crisis (BP 180/100mmHg) and severe headache, was admitted to the operating room for a cesarean section after diagnosis of HELLP syndrome...
November 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27785315/postpartum-acute-liver-dysfunction-a-case-of-acute-fatty-liver-of-pregnancy-developing-massive-intrahepatic-calcification
#6
Khalid Javid Bhat, Rabia Shovkat, Hamad Jeelani Samoon
The function of the liver is particularly affected by the unique physiologic milieu of the pregnancy. Pregnancy-related liver diseases encompass a spectrum of different etiologies that are related to gestation or one of its complications. Hepatic calcification, a rare entity, is usually associated with infectious, vascular, or neoplastic lesions in the liver. To the best of our knowledge, only one case of rapidly occurring pregnancy-related intrahepatic calcification has been documented in a patient with severe eclampsia or hemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome...
December 2015: Gastroenterology Research
https://www.readbyqxmd.com/read/27780546/the-placental-component-and-obstetric-outcome-in-severe-preeclampsia-with-and-without-hellp-syndrome
#7
Eran Weiner, Letizia Schreiber, Ehud Grinstein, Ohad Feldstein, Noa Rymer-Haskel, Jacob Bar, Michal Kovo
OBJECTIVE: We aimed to compare obstetric outcome and placental-histopathology in pregnancies complicated by preeclampsia with severe features with and without HELLP syndrome. METHODS: Labor, maternal characteristics, neonatal outcome and placental histopathology of pregnancies complicated with severe preeclampsia during 2008-2015 were reviewed. Results were compared between those without signs of HELLP syndrome (severe preeclampsia group) and those with concomitant HELLP syndrome (HELLP group)...
November 2016: Placenta
https://www.readbyqxmd.com/read/27734744/evaluation-of-maternal-liver-elasticity-by-acoustic-radiation-force-impulse-elastosonography-in-hypertensive-disorders-of-pregnancy-a-preliminary-descriptive-study
#8
Orkun Cetin, Erbil Karaman, Harun Arslan, Ali Kolusarı, Recep Yıldızhan, Mesut Ozgokce, Abdussamet Batur, Ibrahim Akbudak
PURPOSE: To compare maternal liver elasticity scores by Acoustic Radiation Force Impulse (ARFI) elastosonography in healthy and preeclamptic pregnancies and its association with the severity of the disease. MATERIALS AND METHODS: Forty-two healthy, 33 mild, 33 severe preeclamptic and 28 pregnant women with Hemolysis, Elevated Liver enzymes, and Low Platelets (HELLP) syndrome were included into the study. Maternal liver elasticity was measured by ARFI elastosonography at the first day of puerperium...
October 13, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27694537/microangiopathic-antiphospholipid-antibody-associated-syndrome-in-a-pregnant-lady
#9
G S Kew, J Cho, A Lateef
We describe a gravid 37-year-old Chinese lady with known triple positive primary antiphospholipid syndrome with previous recurrent deep vein thrombosis and early spontaneous miscarriages. She was managed with low-molecular weight heparin, aspirin, hydroxychloroquine, prednisolone and monthly intravenous immunoglobulin.She presented with recurrent per-vaginal bleeding at 22 weeks of gestation and was found to have abruptio placentae. Anti-coagulation was held off. She subsequently delivered a stillborn at 24 weeks and anti-coagulation was restarted...
October 1, 2016: Lupus
https://www.readbyqxmd.com/read/27688632/point-of-care-ultrasonography-of-the-orbit-for-detection-of-retinal-detachment-in-a-patient-with-hemolysis-elevated-liver-enzymes-and-low-platelet-count-syndrome
#10
Gentle Sunder Shrestha, Shayuja Rajbhandari, Shashwat Dhungel, Nutan Sharma, Nimesh Poudel, Dhiraj N Manandhar
Retinal detachment is a rare, but well-known cause of visual impairment in patients with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. With supportive care, patients usually improve, with complete recovery of vision. Bedside ultrasonography of the orbit can be helpful for early detection of retinal detachment in these patients. Here, we present a case of HELLP syndrome presenting with severe visual symptoms. Retinal detachment was detected with point-of-care ocular sonography, which was confirmed with ophthalmoscopic examination...
September 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27680784/a3-oxidative-stress-in-maternal-serum-as-endothelial-dysfunction-marker-in-preeclampsia-an-electron-paramagnetic-resonance-epr-pilot-study
#11
D Mannaerts, E Faes, J Gielis, J Briedé, P Cos, E Van Craenenbroeck, W Gyselaers, J Cornette, M Spaanderman, Y Jacquemyn
AIMS: Oxidative stress is crucial in the pathophysiology of preeclampsia. Reactive oxygen species (ROS) like the superoxide radical O2-, are produced by the ischemic placenta, causing systemic inflammation and endothelial dysfunction. EPR uses microwave radiation and a high magnetic field and is the most direct and reliable method to detect free radicals. We explored the feasibility of determining O2- concentration in maternal serum and compared pre-eclamptic and uncomplicated pregnancies...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27668204/hepatic-infarction-in-a-pregnant-woman-with-antiphospholipid-syndrome-and-triple-antibody-positivity-a-case-report-focusing-on-catastrophic-antiphospholipid-syndrome
#12
Ji-Hye Kim, Cheonga Yee, Jin-Yi Kuk, Suk-Joo Choi, Soo-Young Oh, Cheong-Rae Roh, Jong-Hwa Kim
Pregnant women with antiphospholipid syndrome (APS) carry a high risk of arterial or venous thrombosis. Such thrombotic conditions occur more frequently in patients with triple positivity to antiphospholipid antibodies or with high antibody titers. Hepatic infarction is a rare complication in pregnant women with APS, and it sometimes mimics HELLP syndrome. This report describes a preeclamptic pregnant woman with APS who had high titers of three antiphospholipid antibodies. She experienced severe epigastric pain with elevated liver enzymes; in addition, she had tachycardia and tachypnea...
September 2016: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/27656251/pulmonary-hypertension-imitating-hellp-syndrome
#13
Adam Morton
A case of undiagnosed pulmonary hypertension in a woman with mixed connective tissue disease presenting with microangiopathic haemolysis, thrombocytopenia and elevated liver enzymes imitating severe preeclampsia (HELLP syndrome) is described. Connective tissue disorders are associated with an increased prevalence of pulmonary hypertension. Maternal mortality rates with pulmonary hypertension in pregnancy are extremely high. All women with connective tissue disorders should have pulmonary hypertension excluded by echocardiography before attempting conception...
December 2013: Obstetric Medicine
https://www.readbyqxmd.com/read/27652600/classic-and-global-hemostasis-testing-in-pregnancy-and-during-pregnancy-complications
#14
Fazoil I Ataullakhanov, Ekaterina M Koltsova, Anna N Balandina, Ilya I Serebriyskiy, Tatiana A Vuimo, Mikhail A Panteleev
Pregnancy is associated with a significant procoagulant shift in the hemostatic system balance as well as other metabolic changes. Pregnancy can thereby provoke manifestation of otherwise dormant disorders of hemostasis (e.g., thrombophilia), or even cause new, pregnancy-specific disorders (e.g., HELLP syndrome). Application and interpretation of laboratory assays of hemostasis in pregnancy is particularly challenging, because normal physiological ranges are no longer applicable, and because the most dangerous and complex changes are not detected by classic routine coagulation/platelet assays...
September 21, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27651719/anesthetic-practices-for-patients-with-preeclampsia-or-hellp-syndrome-a-survey
#15
Betül Başaran, Bilge Çelebioğlu, Ahmet Başaran, Seher Altınel, Leyla Kutlucan, James N Martin
OBJECTIVE: Substantial controversy exists regarding anesthetic management for patients with preeclampsia or hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome. Experts, researchers, clinicians, and residents in Turkey were surveyed about their practices. MATERIAL AND METHODS: Questionnaires were distributed to attendees at a national conference, and they were filled out immediately. Anonymous 10-item paper surveys were administered to both residents and non-residents...
2016: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/27651178/hellp-syndrome-altered-hypoxic-response-of-the-fatty-acid-oxidation-regulator-sirt-4
#16
Mareike Sandvoß, Arne Björn Potthast, Frauke von Versen-Höynck, Anibh Martin Das
The hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome is frequently observed in mothers whose offspring have long-chain fatty acid oxidation defects. We previously found that fatty acid oxidation is compromised not only in these inborn errors of metabolism but also in human umbilical vein endothelial cells (HUVECs) from all pregnancies complicated by the HELLP syndrome. Sirtuins are oxidized nicotinamide adenine dinucleotide (NAD(+))dependent deacetylases linked to the metabolic status of the cell...
September 20, 2016: Reproductive Sciences
https://www.readbyqxmd.com/read/27599183/hemolysis-elevated-liver-enzymes-and-low-platelet-syndrome-outcomes-for-patients-admitted-to-intensive-care-at-a-tertiary-referral-hospital
#17
Ender Gedik, Neslihan Yücel, Taylan Sahin, Erdinc Koca, Yusuf Ziya Colak, Turkan Togal
PURPOSE: The aim was to assess outcomes for pregnancies in which hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome develops and the patient requires transfer for critical care. MATERIALS AND METHODS: The cases of women with HELLP syndrome who delivered at our tertiary center or surrounding hospitals and were admitted to the intensive care between January 2007 and July 2012 were retrospectively analyzed. Results were compared for the surviving and non-surviving patients...
September 6, 2016: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/27591063/cryptogenic-postpartum-stroke
#18
Dániel Bereczki, Norbert Szegedi, Zoltán Szakács, István Gubucz, Zsolt May
An estimated 25-40% of ischemic strokes are classified as cryptogenic, which means the cause of the cerebral infarction remains unidentified. One of the potential pathomechanisms - especially among young patients with no cardiovascular risk factors - is paradoxical embolism through a patent foramen ovale. Pregnancy, cesarean delivery and the postpartum period are associated with an increased risk of cerebrovascular events. Factors that may contribute to ischemic strokes during gestation and puerperium include classic cardiovascular risk factors, changes in hemostaseology/hemodynamics, and pregnancy-specific disorders such as pre-eclampsia, eclampsia, postpartum cerebral angiopathy or peripartum cardiomyopathy...
2016: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/27582800/liver-dysfunction-in-pregnancy-an-important-cause-of-maternal-and-perinatal-morbidity-and-mortality-in-pakistan
#19
N Hossain, T Shamsi, E Kuczynski, C J Lockwood, M J Paidas
The objective of this study was to evaluate the maternal and perinatal outcome of women with liver dysfunction during pregnancy. The study involved a prospective observational study design and was carried out at the Dow University of Health Sciences and Civil Hospital Karachi, Pakistan. A total of 800 women, who delivered during the study period from January 2006 to September 2006, constituted the study population. Pregnant women with liver dysfunction underwent evaluation for the aetiology of their liver dysfunction, including screening for hepatitis E...
March 2009: Obstetric Medicine
https://www.readbyqxmd.com/read/27567707/a-mobile-phone-based-approach-to-detection-of-hemolysis
#20
Edikan Archibong, Karthik Raj Konnaiyan, Howard Kaplan, Anna Pyayt
Preeclampsia and HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome are pregnancy-related complications with high rates of morbidity and mortality. HELLP syndrome, in particular, can be difficult to diagnose. Recent work suggests that elevated levels of free cell hemoglobin in blood plasma can, as early as the first trimester, potentially serve as a diagnostic biomarker for impending complications. We therefore developed a point-of-care mobile phone-based platform that can quickly characterize a patient's level of hemolysis by measuring the color of blood plasma...
August 16, 2016: Biosensors & Bioelectronics
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