23
Views
5
CrossRef citations to date
0
Altmetric
Original Article

Hellp, Microangiopathic Hemolytic Anemia, and Preeclampsia

, &
Pages 487-496 | Published online: 07 Jul 2009
 

Abstract

Objective: The main question of the study concerns the specificity of the HELLP syndrome in the context of preeclampsia and other nonobstetric syndromes.

Methods: The design of the study compares pathogenetic hypotheses and qualitative and quantitative alterations described for the HELLP syndrome, preeclampsia, and other microangiopathic nonobstetric syndromes.

Main Outcome Measure (s): Data are collected to demonstrate that HELLP belongs to the family of microangiopathic diseases.

Results: The HELLP syndrome is characterized by hemolysis, elevated liver enzymes, and low platelet count. Its place in the context of complicated pregnancies is still not clearly defined. An in-depth review of the literature shows that hematologic and pathologic findings assumed as typical of the HELLP syndrome are not qualitatively different from those reported to occur, although to a lesser extent, in preeclampsia. Microangiopathic hemolytic anemia (MHA), reflecting endothelial damage, is the cardinal sign of the syndrome, which shares this feature with many other nonobstetric syndromes characterized by the common background of endothelial damage.

Conclusions: Following theoretical considerations and our experience in a nephrological setting, we propose that the HELLP syndrome not be set apart as a separate entity, because it belongs to the circulatory maladaptation syndrome of pregnancy which may be clinically expressed as preeclampsia, among which it is characterized by the severity of the associated microangiopathic hemolytic anemia.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.