HELLP综合征明显恢复后微血管病性溶血性贫血复发。病例报告。
Recurrence of microangiopathic hemolytic anemia after apparent recovery from the HELLP syndrome. A case report.
作者信息
Lombano Frank, Kidder Melissa Y, Lilly Michael, Gollin Yvonne G, Block Barry S
机构信息
Departments of Obstetrics and Gynecology, Medicine and Microbiology, Center for Molecular Biology, Loma Linda University Medical Center, Loma Linda, California, USA.
出版信息
J Reprod Med. 2002 Oct;47(10):875-7.
BACKGROUND
The syndrome of hemolytic anemia, elevated liver enzymes and low platelets (HELLP) can accompany preeclampsia and eclampsia. Delivery of the infant usually results in improvement in the mother's condition, with the recovery time dependent on the severity of the disease. We report a case of eclampsia with the HELLP syndrome in which microangiopathic hemolytic anemia (MAHA) and thrombocytopenia recurred after apparent recovery.
CASE
A 28-year-old woman, gravida 4, para 0, therapeutic abortion 3, presented with signs and symptoms of severe preeclampsia and became eclamptic. The patient's condition improved as expected following cesarean delivery. However, the hemolytic anemia recurred and was successfully treated with a course of fresh frozen plasma (FFP).
CONCLUSION
Hemolytic anemia in women with eclampsia and the HELLP syndrome occurs secondary to microvascular endothelial damage. In this case resolution of the HELLP syndrome and eclampsia occurred, as expected, in two to three days; however, MAHA and low platelets recurred on day 4. Treatment of MAHA with FFP was successful.
背景
溶血、肝酶升高和血小板减少综合征（HELLP）可伴随先兆子痫和子痫出现。婴儿分娩通常会使母亲的病情好转，恢复时间取决于疾病的严重程度。我们报告一例伴有HELLP综合征的子痫病例，其中微血管病性溶血性贫血（MAHA）和血小板减少症在明显恢复后复发。
病例
一名28岁女性，孕4产0，有3次治疗性流产史，出现重度先兆子痫的症状和体征并发生子痫。剖宫产术后患者的病情如预期般好转。然而，溶血性贫血复发，并通过一个疗程的新鲜冰冻血浆（FFP）成功治疗。
结论
子痫和HELLP综合征女性的溶血性贫血继发于微血管内皮损伤。在本病例中，HELLP综合征和子痫如预期在两到三天内得到缓解；然而，MAHA和血小板减少症在第4天复发。用FFP治疗MAHA取得成功。
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