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. 2015:2015:123408.
doi: 10.1155/2015/123408. Epub 2015 Aug 27.

Response to Plasmapheresis Measured by Angiogenic Factors in a Woman with Antiphospholipid Syndrome in Pregnancy

Karoline Mayer-Pickel  1 , Sabine Horn  2 , Uwe Lang  1 , Mila Cervar-Zivkovic  1
Affiliations

Response to Plasmapheresis Measured by Angiogenic Factors in a Woman with Antiphospholipid Syndrome in Pregnancy

Karoline Mayer-Pickel et al. Case Rep Obstet Gynecol. 2015.

Abstract

An imbalance of angiogenic and antiangiogenic placental factors such as endoglin and soluble fms-like tyrosine kinase 1 has been implicated in the pathophysiology of preeclampsia. Extraction of these substances by plasmapheresis might be a therapeutical approach in cases of severe early-onset preeclampsia. Case Report. A 21-year-old primigravida with antiphospholipid syndrome developed early-onset preeclampsia at 18 weeks' gestation. She was treated successfully with plasmapheresis in order to prolong pregnancy. Endoglin and sflt-1-levels were measured by ELISA before and after treatment. Endoglin levels decreased significantly after treatment (p < 0.05) and showed a significant decrease throughout pregnancy. A rerise of endoglin and sflt-1 preceded placental abruption 4 weeks before onset of incident. Conclusion. Due to the limited long-term therapeutical possibilities for pregnancies complicated by PE, plasmapheresis seems to be a therapeutical option. This consideration refers especially to pregnancies with early-onset preeclampsia, in which, after first conventional treatment of PE, prolongation of pregnancy should be above all.

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Figures

Figure 1
Figure 1
Endoglin, sflt-1, and plgf levels measured throughout pregnancy.
Figure 2
Figure 2
sflt-1, measured immediately before and after treatment and at the following day.
Figure 3
Figure 3
plgf, measured immediately before and after treatment and at the following day.
See this image and copyright information in PMC

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