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Published on: March 14, 2017
Plasma exchange therapy in HELLP syndrome: a single-center experience
Ziya Bayraktaroğlu1, Fikret Demirci, Ozcan Balat
1Departments of Pediatrics and Transfusion Medicine, Gaziantep University, School of Medicine, Gaziantep, Turkey. bayraktar@gantep.edu.tr
Summary
Plasma exchange therapy effectively treated severe cases of hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome, improving platelet counts. However, fulminant HELLP syndrome cases did not respond to this treatment.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Critical Care Medicine
Background:
- HELLP syndrome is a severe condition characterized by hemolysis, elevated liver enzymes, and low platelets.
- It poses significant risks to maternal health, necessitating effective treatment strategies.
Purpose of the Study:
- To evaluate the efficacy of plasma exchange (PE) as a therapeutic intervention for HELLP syndrome.
- To assess the response of different severity classes of HELLP syndrome to PE therapy.
Main Methods:
- A cohort of 13 patients diagnosed with HELLP syndrome according to Sibai's criteria were treated with one or two sessions of PE post-delivery.
- Patients were classified into severity classes based on platelet counts, with a subset defined as fulminant type based on AST and LDH levels.
Main Results:
- Plasma exchange therapy led to a rapid increase in platelet counts in most patients.
- All patients in class-1 and class-2 HELLP syndrome survived the treatment.
- Two patients with fulminant HELLP syndrome did not survive, indicating a lack of response to PE.
Conclusions:
- Plasma exchange is an effective treatment for severe HELLP syndrome, particularly for classes 1 and 2.
- Fulminant cases of HELLP syndrome appear refractory to plasma exchange therapy, suggesting a need for alternative or adjunctive treatments.