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VOLUME 15 , ISSUE 2 ( April, 2011 ) > List of Articles

CASE REPORT

Life-threatening postpartum hemolysis, elevated liver functions tests, low platelets syndrome versus thrombocytopenic purpura - Therapeutic plasma exchange is the answer

J. M. Dua, Geeta Chadha, Manav Manchanda

Keywords : Cerebral venous thrombosis, life-threatening postpartum disorders, pregnancy-related microangiopathic disorders

Citation Information : Dua JM, Chadha G, Manchanda M. Life-threatening postpartum hemolysis, elevated liver functions tests, low platelets syndrome versus thrombocytopenic purpura - Therapeutic plasma exchange is the answer. Indian J Crit Care Med 2011; 15 (2):126-129.

DOI: 10.4103/0972-5229.83016

License: CC BY-ND 3.0

Published Online: 00-04-2011

Copyright Statement:  Copyright © 2011; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

The differential diagnosis of life-threatening microangiopathic disorders in a postpartum female includes severe preeclampsia-eclampsia, hemolysis, elevated liver functions tests, low platelets syndrome and thrombotic thrombocytopenic purpura. There is considerable overlapping in the clinical and laboratory findings between these conditions, and hence an exact diagnosis may not be always possible. However, there is considerable maternal mortality and morbidity associated with these disorders. This case underlines the complexity of pregnancy-related microangiopathies regarding their differential diagnosis, multiple organ dysfunction and role of therapeutic plasma exchange in their management.


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  1. Sibai BM. Imitators of severe preeclampsia. Obstet Gynecol 2007;109:956-66.
  2. Sibai BM. Diagnosis, controversies, and management of the syndrome of hemolysis, elevated liver enzymes, and low platelet count. Obstet Gynecol 2004;103:981-91.
  3. Martin JN Jr, Files JC, Blake PG, Norman PH, Martin RW, Hess LW, et al. Plasma exchange for preeclampsia. I. Postpartum use for persistently severe preeclampsia-eclampsia with HELLP syndrome. Am J Obstet Gynecol 1990;162:126-37.
  4. Haram K, Svendsen E, Abildgaard U. The HELLP syndrome: Clinical issues and management. A Review. BMC Pregnancy Childbirth 2009;9:8.
  5. Stella CL, Dacus J, Guzman E, Dhillon P, Coppage K, How H, et al. The diagnostic dilemma of thrombotic thrombocytopenic purpura/hemolytic uremic syndrome in the obstetric triage and emergency department: Lessons from 4 tertiary hospitals. Am J Obstet Gynecol 2009;200:381.
  6. Myers L. Postpartum plasma exchange in a woman with suspected thrombotic thrombocytopenic purpura (TTP) vs. hemolysis, elevated liver enzymes, and low platelet syndrome (HELLP): A case study. Nephrol Nurs J 2010;37:399-402.
  7. Altamura C, Vasapollo B, Tibuzzi F, Novelli GP, Valensise H, Rossini PM, et al. Postpartum cerebellar infarction and haemolysis, elevated liver enzymes, low platelet (HELLP) syndrome. Neurol Sci 2005;26:40-2.
  8. Soh Y, Yasuhi I, Nakayama D, Ishimaru T. A case of postpartum cerebellar infarction with hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome. Gynecol Obstet Invest 2002;53:240-2.
  9. Albers GW, Amarenco P, Easton JD, Sacco RL, Teal P. Antithrombotic and thrombolytic therapy for ischemic stroke: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008;133:630S-69S.
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