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血浆置换在溶血、肝酶升高和血小板减少(HELLP)综合征中的作用

Role of Plasmapheresis in Hemolysis, Elevated Liver Enzymes and Low Platelets (HELLP) Syndrome.

作者信息

Taj Sobaan, Mujtaba Mohamed, Miller Brett, Dandu Sowmaya, Austin Christopher P, Ali Akbar Usman, Sanekommu Harshavardhan, Hossain Mohammad A

机构信息

Internal Medicine, Jersey Shore University Medical Center, Neptune Township, USA.

Gastroenterology, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.

出版信息

Cureus. 2023 Feb 27;15(2):e35520. doi: 10.7759/cureus.35520. eCollection 2023 Feb.

Abstract

Hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome is a rare abnormality comprising a series of symptoms that make up a syndrome. It usually happens during pregnancy or right after delivery. We describe a case of a 31-year-old female G4P2A2 (Gravida 4 Para 2 Abortions 2) who presented to the hospital for normal vaginal delivery but immediately postpartum developed HELLP syndrome. Acute fatty liver of pregnancy was a differential that the patient also met the criteria for. Her condition improved after starting her on plasmapheresis without considering hepatic transplantation. We emphasize distinguishing the overlap of symptoms between HELLP syndrome vs. acute fatty liver of pregnancy and the outcomes of plasmapheresis in managing HELLP syndrome without needing hepatic transplantation.

摘要

溶血、肝酶升高和血小板减少(HELLP)综合征是一种罕见的异常情况,由一系列症状组成一种综合征。它通常发生在孕期或产后不久。我们描述了一例31岁女性,孕4产2流2(孕4、产2、流产2),因正常阴道分娩入院,但产后立即发生了HELLP综合征。妊娠急性脂肪肝是该患者也符合其标准的鉴别诊断。在未考虑肝移植的情况下,对她开始进行血浆置换后病情有所改善。我们强调要区分HELLP综合征与妊娠急性脂肪肝症状的重叠情况,以及血浆置换在无需肝移植治疗HELLP综合征中的效果。

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