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plasmapheresis hellp

Inês Martins, Madalena Gomes Conceição, Paulo Pereira Gomes, Nuno Clode
A pregnancy complicated by typical hemolytic uremic syndrome (HUS) and hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome is reported. At 20 weeks of gestation, a case of HUS was diagnosed, with Shiga toxin-producing Escherichia coli identified. Plasmapheresis allowed continuation of the pregnancy for 5 weeks. Superimposed preeclampsia and HELLP syndrome were diagnosed after the establishment of nephrotic range proteinuria, hypertension and recurrence of hemolysis. This is a singular case, as it demonstrates that HELLP syndrome can superimpose upon HUS, a fact that can impact future research on reproductive immunology...
April 2017: Revista Brasileira de Ginecologia e Obstetrícia
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...
April 2017: Lupus
Raffaella Cravero, Gianluigi Ardissino, Umberto Colageo, Piernicola Staffa, Elena Bruschetta, Serena Maroni, Eirini Karvela, Ermanno Spagarino, Velia Ruggeri, Roberto Jura
Pregnancy-associated thrombotic microangiopathy (TMA) is a rare condition, but it is burdened by a significant perinatal and maternal morbidity as well as mortality. We describe the case of a 33-year-old woman, who developed a TMA at the 36th week of gestation characterized by increased LDH, haptoglobin consumption, schistocytes, thrombocytopenia and acute renal failure requiring dialysis. There were not gestational hypertension nor proteinuria until the day of hospitalization. ADAMTS 13 deficiency was ruled out and the patient did not have diarrhea...
July 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Antonio F Saad, Jorge Roman, Aaron Wyble, Luis D Pacheco
Introduction Early diagnosis of atypical uremic-hemolytic syndrome may be challenging during the puerperium period. Correct diagnosis and timely management are crucial to improve outcomes. Background Pregnancy-associated atypical hemolytic-uremic syndrome (p-aHUS) is a rare condition characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. Triggered by pregnancy, genetically predisposed women develop the syndrome, leading to a disastrous hemolytic disease characterized by diffuse endothelial damage and platelet consumption...
March 2016: American Journal of Perinatology Reports
Jamshid Vafaeimanesh, Azam Nazari, Fatemeh Hosseinzadeh
BACKGROUND: HELLP syndrome is an important complications in pregnancy which increases maternal and fetal mortality. This disease usually remits with supportive treatment which includes prescription of corticosteroid, magnesium sulfate, stabilization of mother and pregnancy termination. Plasmapheresis is a treatment of choice which improves clinical outcomes in complicated cases. CASE PRESENTATION: A 22-year-old woman with coagulopathy and respiratory distress and 33-year-old woman with a history of cerebellar medulloblastoma at 32-weeks' gestation developed thrombocytopenia due to HELLP syndrome were treated with plasmapheresis were described...
2014: Caspian Journal of Internal Medicine
Ashley Fyfe-Brown, Gwen Clarke, Kara Nerenberg, Sujata Chandra, Venu Jain
Thrombotic thrombocytopenia purpura (TTP) is an infrequent but serious disease. Pregnancy is a known risk factor for presentation or relapse of TTP. Difficulties in differentiating TTP from preeclampsia/HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome, and current treatment recommendations are discussed in this case report. A woman with previously treated and stable TTP had a relapse at 36 weeks' gestation. Careful surveillance led to an early diagnosis. Severe disease in the peripartum period was treated successfully with cryosupernatant plasma-based plasmapheresis and platelet transfusion, with good maternal and neonatal outcomes...
May 2013: American Journal of Perinatology Reports
W A Heggermont, C Verhelst, K De Wilde, M De Paepe, F Lacquet, A Vonck
We report on a 27-year-old woman who developed severe arterial hypertension on a background of general malaise within 48 hours after vaginal delivery, suggesting severe acute-onset pre-eclampsia. Concomitant biochemical observations of haemolysis, elevated liver tests and low platelets lead to the diagnosis of (post-partum) HELLP syndrome. Our patient was transferred immediately to the intensive care unit (ICU), where she underwent plasmapheresis in combination with intravenous glucocorticoids, nicardipine and labetalol...
September 2012: Acta Clinica Belgica
Jay A Graham, Brenton R Franklin, Patrick G Jackson
Hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome describes a cohort of disease processes that may have devastating consequences for the peripartum patient. Although the hemopoetic and hepatic systems are classically involved, we illustrate a case of walled-off pancreatic necrosis occurring in a woman with HELLP syndrome. Initially managed with resuscitation, steroids, and plasmapheresis, the patient developed necrotizing pancreatitis that overtime became walled-off. Despite attempts at percutaneous drainage, the patient ultimately had a video-assisted retroperitoneal debridement...
June 2012: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Julia Gallwas
No abstract text is available yet for this article.
January 27, 2011: MMW Fortschritte der Medizin
Simone Appenzeller, Fernando H C Souza, Alexandre Wagner Silva de Souza, Yehuda Shoenfeld, Jozélio Freire de Carvalho
OBJECTIVE: To perform a systematic review of the association between antiphospholipid antibodies, antiphospholipid syndrome (APS), and HELLP syndrome (Hemolysis; Elevated Liver enzymes; Low Platelet count), describing clinical features, outcome, pathophysiological findings, and treatment. METHODS: We performed a literature search in PubMed using the following MeSH entry terms: HELLP syndrome, anticardiolipin antibodies, lupus anticoagulant, antiphospholipid antibodies, and antiphospholipid syndrome...
December 2011: Seminars in Arthritis and Rheumatism
Marloes Derks, Martijn A Oudijk, Flip van der Made, Bert-Jan H van den Born, Joris A M van der Post
Antiphospholipid syndrome (APS) had been previously diagnosed in three pregnant women aged 32, 27 and 36 years, respectively. All three of them were using low-molecular weight heparin for the prevention of thromboembolic complications. The first two women were admitted because of foetal growth retardation. In the first patient, either HELLP syndrome or exacerbation of APS was suspected. A caesarean section was performed due to foetal distress. The patient's condition deteriorated further postoperatively. Multiple infarctions in liver and placenta were identified...
2011: Nederlands Tijdschrift Voor Geneeskunde
Agnes Haris, József Arányi, Henrik Braunitzer, Eva Kálmán, Zoltán Merán, Mariann Soltész, Kálmán Polner
UNLABELLED: Plasmapheresis is an effective treatment modality in several immunological kidney diseases. It is also indicated in certain neurological and hematological abnormalities, and some other diseases. AIMS: In this study the indications and outcomes of the plasma exchange treatments performed in the Plasmapheresis Unit of the authors during the last 12 years are summarized, and the findings are compared to those published in the literature. The procedure, mechanisms of action and adverse effects are also briefly discussed...
July 10, 2011: Orvosi Hetilap
Eszter Márta Kovács, Attila Molvarec, János Rigó, Antal Szabó
We report a case of a 26-year-old primigravid woman, believed to have HELLP (Hemolysis, Elevated Liver enzymes, Low Platelet count) syndrome, which turned out to be a thrombotic thrombocytopenic purpura (TTP) bout. At the 40th gestational week, based on the clinical picture of HELLP syndrome, a cesarean section was performed and a dysmature male newborn was delivered. Afterwards, clinical symptoms and laboratory abnormalities persisted. Severe ADAMTS13 deficiency with the presence of inhibitory anti-ADAMTS13 antibodies revealed acquired thrombotic thrombocytopenic purpura bout, which was complicated with bilateral vision decrease due to bilateral retinal detachment...
October 2011: Journal of Obstetrics and Gynaecology Research
A V Kulikov, S V Spirin, S I Blauman
HELLP-syndrome is one of the most severe variants of liver failure in pregnancy. The incidence among pregnant patients is 0.5-0.9%, and in presence of severe preeclampsia and eclampsy the incidence is 10-20%. Pathogenesis of HELLP-syndrome has common features with pathogenesis of preeclampsia, DIC-syndrome and fatty hepatosis of pregnant, this is confirmed by pathomorphological changes of liver in women with HELLP-syndrome. Efficacy of conservative therapy (corticosteroids, magnesium sulphate, hypotensive therapy, hepatoprotectors) and disintoxication methods (plasmapheresis, MARS-therapy) is not evident...
November 2010: Anesteziologiia i Reanimatologiia
R Sidi, R Rodak, G Stüssi
No abstract text is available yet for this article.
August 11, 2010: Praxis
Maria Teresa Pirrotta, Alessandro Bucalossi
Thrombotic thrombocytopenic purpura (TTP), which is typically characterized by fever and central nervous system manifestations and hemolytic uremic syndrome (HUS), in which renal failure is a prominent feature are the most common thrombotic microangiopathies (TMAs). TTP is usually associated with a severe deficiency of ADAMTS13 [a metalloproteinase involved in the degradation of von Willebrand factor (vWF) multimers], causing excessive accumulation of ultra-large vWF multimers and platelet aggregation with organ failure...
June 2010: Cardiovascular & Hematological Disorders Drug Targets
F J García-Miguel, M F Mirón Rodríguez, M J Alsina Aser
Acute renal failure is a serious complication of pregnancy associated with a high rate of morbidity and mortality; the incidence is currently 1 per 10,000 pregnancies. The most common causes are gestational hypertension, bleeding, sepsis, and intrinsic renal disease. Other less common pregnancy-related syndromes, such as HELLP syndrome or thrombotic microangiopathy, may also lead to kidney failure. Hemolytic uremic syndrome and thrombotic thrombocytopenic purpura are forms of thrombotic microangiopathy and although neither is specific to pregnancy, the incidence of these entities rises during gestation...
February 2009: Revista Española de Anestesiología y Reanimación
J Gallwas, H Ackermann, W Friedmann
Thrombotic thrombocytopenic purpura (TTP) represents a rare complication mainly in the second trimester and can, in its early stage, mimic HELLP syndrome. At 38 weeks of gestation, a 40-year-old primigravida with elevated blood pressure, thrombocytopenia and elevated liver enzymes was diagnosed with HELLP syndrome. Despite a Ceasarean section her laboratory parameters remained pathological with severe thrombocytopenia and hemolysis. In addition, the patient developed neurological comatose-like symptoms. The diagnosis of TTP was made after further tests revealed fragmented red cells in the blood, autoantibodies against ADAMTS13 and a nearly total loss of ADAMST13 plasma activity...
April 2008: Zeitschrift Für Geburtshilfe und Neonatologie
Katalin Veres, Károly Papp, Gabriella Lakos, Edit Szomják, Zoltán Szekanecz, Gyula Szegedi, Pál Soltész
Authors present the first Hungarian case of a young pregnant woman with the association of antiphospholipid syndrome (APS) and hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. After the onset of severe preeclampsia, the pregnancy was terminated but the patient's condition continued to worsen. New symptoms of APS, including deep vein thrombosis and ischemic nervus opticus lesion, developed in the patient followed by the onset of acute respiratory distress syndrome, which required respiratory therapy...
January 2008: Clinical Rheumatology
L Bernd Zimmerhackl, Nesir Besbas, Therese Jungraithmayr, Nicole van de Kar, Helge Karch, Diana Karpman, Daniel Landau, Chantal Loirat, Willem Proesmans, Friederike Prüfer, Gianfranco Rizzoni, Mark C Taylor
Hemolytic uremic syndrome (HUS) includes a heterogeneous group of hemolytic disorders. Among the identified causes of HUS are infections, particularly infections with Shiga toxin-producing ESCHERICHIA COLI (STEC), complement disorders, and disorders interfering with the degradation of von Willebrand factor (VWF). Other causes for atypical HUS include the cobalamin metabolism; pregnancy/hemolysis, elevated liver enzymes, and low platelets syndrome (HELLP); drugs; and other disorders (e.g., systemic diseases appearing as HUS, such as systemic lupus erythematosus and rejection after transplantation)...
March 2006: Seminars in Thrombosis and Hemostasis
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