Differentiation between severe HELLP syndrome and thrombotic microangiopathy, thrombotic thrombocytopenic purpura and other imitators

European Journal of Obstetrics and Gynecology and Reproductive Biology

Volumn 189, Issue , 2015, Pages 68-72

  Pourrat, O ^a   Coudroy, R ^a   Pierre, F ^a  

^a UNIVERSITÉ DE POITIERS   (France)

Author keywords

HELLP syndrome; Hemolytic uremic syndrome; Pre eclampsia; Thrombotic microangiopathy; Thrombotic thrombocytopenic purpura

Indexed keywords

VON WILLEBRAND FACTOR CLEAVING PROTEINASE;

ANTIPHOSPHOLIPID SYNDROME; CLINICAL DECISION MAKING; CLINICAL PRACTICE; DIAGNOSTIC ERROR; DIFFERENTIAL DIAGNOSIS; DISSEMINATED INTRAVASCULAR CLOTTING; ENZYME ACTIVITY; FATTY LIVER; HELLP SYNDROME; HEMOLYSIS; HUMAN; MATERNAL WELFARE; PREECLAMPSIA; PREGNANT WOMAN; PRIORITY JOURNAL; REVIEW; SEPSIS; SYSTEMIC LUPUS ERYTHEMATOSUS; THROMBOTIC THROMBOCYTOPENIC PURPURA; FEMALE; PREGNANCY;

ANTIPHOSPHOLIPID SYNDROME; DIAGNOSIS, DIFFERENTIAL; FATTY LIVER; FEMALE; HELLP SYNDROME; HUMANS; LUPUS ERYTHEMATOSUS, SYSTEMIC; PRE-ECLAMPSIA; PREGNANCY; PURPURA, THROMBOTIC THROMBOCYTOPENIC; SEPSIS; THROMBOTIC MICROANGIOPATHIES;

EID: 84928898364     PISSN: 03012115     EISSN: 18727654     Source Type: Journal    
DOI: 10.1016/j.ejogrb.2015.03.017     Document Type: Review

References (38)

1. L. Weinstein Syndrome of hemolysis, elevated liver enzymes, and low platelet count: a severe consequence of hypertension Am J Obstet Gynecol 142 1982 159 167
2. M.L. Schwartz, and W.E. Brenner The obfuscation of eclampsia by thrombotic thrombocytopenic purpura Am J Obstet Gynecol 131 1978 18 24
3. J.N. Martin Jr., and C. Stedman Imitators of preeclampsia and HELLP syndrome Obstet Gynecol Clin N Am 18 1991 181 198
4. B. Sibai Imitators of severe preeclampsia Obstet Gynecol 109 2007 956 966
5. C.L. Stella, J. Dacus, and E. Guzman 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 200 2009 381.e1 381.e6
6. J.F. Rehberg, C.M. Briery, W.T. Hudson, J.A. Bofill, and J.N. Martin Jr. Thrombotic thrombocytopenic purpura masquerading as hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome in late pregnancy Obstet Gynecol 108 2006 817 820
7. M. Scully, B.J. Hunt, and S. Benjamin Guidelines on the diagnosis and management of thrombotic thrombocytopenic purpura and other thrombotic microangiopathies Br J Haematol 158 2012 323 335
8. A. Lattuada, E. Rossi, C. Calzarossa, R. Candolfi, and P.M. Mannucci Mild to moderate reduction of a von Willebrand factor cleaving protease (adamts-13) in pregnant women with HELLP microangiopathic syndrome Haematologica 88 2003 1029 1034
9. A. Ohkuchi, H. Minakami, I. Suzuki, A. Ayustawati Izumi, and I. Sato Liver dysfunction in pregnancy: CMV-induced hepatitis or HELLP syndrome? J Obstet Gynaecol Res 27 2001 319 323
10. R.S. Gupta, S. Rajaram, N. Goel, and K.C. Singh Severe folate deficiency mimicking HELLP syndrome - report of two cases J Indian Med Assoc 101 2003 32 34
11. S.P. Higgins, L.P. Mc Mahan, and S.P. Brennecks Paroxysmal nocturnal haemoglobinuria in pregnancy - not to be confused with preeclampsia or HELLP syndrome: case report and literature review J Obstet Gynaecol 24 2004 83 85
12. J.E. Fonseca, F. Méndez, C. Cataño, and F. Arias Dexamethasone treatment does not improve the outcome of women with HELLP syndrome: a double-blind, placebo-controlled, randomized clinical trial Am J Obstet Gynecol 193 2005 1591 1598
13. L. Katz, M.M. de Amorim, J.N. Figueiroa, and J.L. Pinto e Silva Postpartum dexamethasone for women with hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome: a double-blind, placebo-controlled, randomized clinical trial Am J Obstet Gynecol 198 2008 283.e1 283.e8
14. D.M. Woudstra, S. Chandra, G.J. Hofmeyr, and T. Dowswell Corticosteroids for HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome in pregnancy Cochrane Database Syst Rev 9 2010 CD008148
15. E.F. Magann, K.G. Perry Jr., E.F. Meydrech, R.L. Harris, S.P. Chauhan, and J.N. Martin Jr. Postpartum corticosteroids: accelerated recovery from the syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP) Am J Obstet Gynecol 171 1994 1154 1158
16. J.N. Martin Jr., C.H. Rose, and C.M. Briery Understanding and managing hellp syndrome: the integral role of aggressive glucocorticoids for mother and child Am J Obstet Gynecol 195 2006 914 934
17. M.A. Castro, M.J. Fassett, T.B. Reynolds, K.J. Shaw, and T.M. Goodwin Reversible peripartum liver failure: a new perspective on the diagnosis, treatment, and cause of acute fatty liver of pregnancy, based on 28 consecutive cases Am J Obstet Gynecol 181 1999 389 395
18. C.M. Evelyn, J.W. Kim, and A.L. Wong HELLP-like syndrome associated with hepatic necrosis in a patient with systemic lupus erythematosus J Clin Rheumatol 7 2001 179 183
19. S. Appenzeller, F.H. Souza, A. Wagner Silva de Souza, Y. Shoenfeld, and J.F. de Carvalho HELLP syndrome and its relationship with antiphospholipid syndrome and antiphospholipid antibodies Semin Arthritis Rheum 41 2011 517 523
20. J.N. George How I treat patients with thrombotic thrombocytopenic purpura: 2010 Blood 116 2010 4060 4069
21. L.I. Gordon, H.C. Kwaan, and E.C. Rossi Deleterious effects of platelet transfusions and recovery thrombocytosis in patients with thrombotic microangiopathy Semin Hematol 24 1987 194 201
22. O. Pourrat, G. Touchard, and R. Robert A kidney biopsy is clearly mandatory to confirm the indication of plasma exchanges in adult haemolytic uraemic syndrome Ann Med Interne (Paris) 145 1994 369 372
23. F. Fakhouri, C. Vercel, and V. Frémeaux-Bacchi Obstetric nephrology: AKI and thrombotic microangiopathies in pregnancy Clin J Am Soc Nephrol 7 2012 2100 2106
24. S.D. Keiser, K.W. Boyd, and J.F. Rehberg A high LDH to AST ratio helps to differentiate pregnancy-associated thrombotic thrombocytopenic purpura (TTP) from HELLP syndrome J Matern Fetal Neonatal Med 25 2012 1059 1063
25. H.M. Tsai Pathophysiology of thrombotic thrombocytopenic purpura Int J Hematol 91 2010 1 19
26. H.M. Tsai The kidney in thrombotic thrombocytopenic purpura Minerva Med 98 2007 731 747
27. K.A. Abraham, M. Kennelly, A.M. Dorman, and J.J. Walshe Pathogenesis of acute renal failure associated with the HELLP syndrome: a case report and review of the literature Eur J Obstet Gynecol Reprod Biol 108 2003 99 102
28. A. Sánchez-Luceros, C.E. Farías, and M.M. Amaral von Willebrand factor-cleaving protease (ADAMTS13) activity in normal non-pregnant women, pregnant and post-delivery women Thromb Haemost 92 2004 1320 1326
29. O. Pourrat, R. Coudroy, and M. Pierre ADAMTS13 deficiency in severe postpartum HELLP syndrome Br J Haematol 163 2013 409 410
30. J.N. Martin Jr., K.G. Perry Jr., and W.E. Roberts Plasma exchange for preeclampsia: III. Immediate peripartal utilization for selected patients with HELLP syndrome J Clin Apher 9 1994 162 165
31. J.N. Martin Jr., J.C. Files, P.G. Blake, K.G. Perry Jr., J.C. Morrison, and P.H. Norman Postpartum plasma exchange for atypical preeclampsia-eclampsia as HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome Am J Obstet Gynecol 172 1995 1107 1125
32. J.N. Martin Jr., J.C. Files, and P.G. Blake Plasma exchange for preeclampsia. I. Postpartum use for persistently severe preeclampsia-eclampsia with HELLP syndrome Am J Obstet Gynecol 162 1990 126 137
33. M.Y. Owens, J.N. Martin Jr., and K. Wallace Postpartum thrombotic microangiopathic syndrome Transfus Apher Sci 48 2013 51 57
34. L. Katz, M. Amorim, J.P. Souza, S.M. Haddad, J.G. Cecatti COHELLP Study Group COHELLP: collaborative randomized controlled trial on corticosteroids in HELLP syndrome Reprod Health 10 2013 28
35. J.N. Martin Jr., C.M. Briery, C.H. Rose, M.T. Owens, J.A. Bofill, and J.C. Files Postpartum plasma exchange as adjunctive therapy for severe acute fatty liver of pregnancy J Clin Apher 23 2008 138 143
36. F. Jin, M. Cao, Y. Bai, Y. Zhang, Y. Yang, and B. Zhang Therapeutic effects of plasma exchange for the treatment of 39 patients with acute fatty liver of pregnancy Discov Med 13 2012 369 373
37. J.A. Gómez-Puerta, R. Cervera, and G. Espinosa Catastrophic antiphospholipid syndrome during pregnancy and puerperium: maternal and fetal characteristics of 15 cases Ann Rheum Dis 66 2007 740 746
38. K.K. Booth, D.R. Terrell, S.K. Vesely, and J.N. George Systemic infections mimicking thrombotic thrombocytopenic purpura Am J Hematol 86 2011 743 751