HELLP症候群と急性血液浄化療法

概要

論文の詳細を見る
HELLP syndrome is characterized by a triad of hemolysis, elevated liver enzymes, and low platelets. Although the syndrome is often associated with pregnancy-induced hypertension (PIH), the etiology is still unknown. In general, the therapeutic modalities in the syndrome are similar to those in severe preeclampsia, and the efficacy of plasma exchange (PE) for the severe form of the syndrome is controversial. We experienced 9 cases of HELLP syndrome over a 4-year period. Cesarean sections were performed in all patients between 25 to 36 weeks' gestation. PE was performed for three of the 9 patients. The PE group showed lower nadir platelet counts (< 50,000 cells/mm^3), higher peak LDH values (> 8,000 IU/L), and higher peak bilirubin values (<5.0 mg/dl) thatn those of the 6 cases without PC. Although LDH and bilirubin values decreased rather rapidly after cesarean sections in the patients without PE, those in the PE group showed an increase after delivery and prompt decrease after PE. We have not encountered any side effect attributed to PE. All cases recovered without any sequalae. Our experience mentioned above shows that PE itself can be done safely, and may indicate that PE may play some role in alleviating severe HELLP syndrome.
日本アフェレシス学会の論文
1999-02-28