Association of HELLP syndrome with primary antiphospholipid syndrome--a case report

Clin Rheumatol. 2008 Jan;27(1):111-3. doi: 10.1007/s10067-007-0687-x. Epub 2007 Aug 8.

Abstract

Authors present the first Hungarian case of a young pregnant woman with the association of antiphospholipid syndrome (APS) and hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. After the onset of severe preeclampsia, the pregnancy was terminated but the patient's condition continued to worsen. New symptoms of APS, including deep vein thrombosis and ischemic nervus opticus lesion, developed in the patient followed by the onset of acute respiratory distress syndrome, which required respiratory therapy. Intensive treatment with plasmapheresis, high-dose intravenous immunoglobulin, high-dose corticosteroids, cyclophosphamide, and anticoagulants eventually led to full recovery. There have been only few scattered reports in the literature on the association of HELLP syndrome and APS, which was successfully managed with the combination of various immunosuppressive and immunomodulatory treatment modalities.

Publication types

  • Case Reports

MeSH terms

  • Abortion, Therapeutic
  • Adult
  • Antibodies, Antiphospholipid / analysis*
  • Anticoagulants / therapeutic use
  • Antiphospholipid Syndrome / immunology*
  • Antiphospholipid Syndrome / pathology
  • Antiphospholipid Syndrome / therapy
  • Cyclophosphamide / therapeutic use
  • Dose-Response Relationship, Drug
  • Female
  • Glucocorticoids / therapeutic use
  • HELLP Syndrome / immunology*
  • HELLP Syndrome / pathology
  • HELLP Syndrome / therapy
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Liver Diseases / pathology
  • Plasmapheresis
  • Pre-Eclampsia / pathology
  • Pregnancy
  • Treatment Outcome

Substances

  • Antibodies, Antiphospholipid
  • Anticoagulants
  • Glucocorticoids
  • Immunoglobulins, Intravenous
  • Cyclophosphamide