Postpartum thrombotic microangiopathic syndrome

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• 作者：Michelle Y. Owens ; ^{myowens@umc.edu} ; James N. Martin Jr. ; Kedra Wallace ; Sharon D. Keiser ; Marc R. Parrish ; Kiran B. Tam Tam ; Rick W. Martin
• 关键词：Postpartum plasma exchange ; Thrombotic microangiopathy ; HELLP syndrome
• 刊名：Transfusion and Apheresis Science
• 出版年：2013
• 出版时间：February, 2013
• 年：2013
• 卷：48
• 期：1
• 页码：51-57
• 全文大小：378 K

文摘

Objective

Characterization of syndromes for patients with life-threatening, progressively worsening hemolysis-elevated-liver-enzymes-and-platelet (HELLP) syndrome-like diseases and with thrombotic microangiopathies.

Retrospective study design

Patients who underwent postpartum plasma-exchange (PPEX) for preeclampsia-related, and microangiopathy/coagulopathy illnesses unresponsive to medical therapy between 1994 and 2008 in our center and elsewhere.

Results

Nine patients were treated with PPEX in our center with 78 % maternal survival. Treatment with PPEX increased platelet levels (p = 0.048), decreased serum lactic dehydrogenase (p = 0.0012) and aspartate aminotransferase (p = 0.0001).

Conclusion

Nineteen patients from publications combined with our patients suggest five categories of postpartum thrombotic microangiopathy syndrome that exhibit HELLP syndrome criteria and respond to PPEX.