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. 2023 Feb 20;9(1):9.
doi: 10.1186/s40981-023-00602-2.

Therapeutic plasma exchange in postpartum HELLP syndrome: a case report

Nana Kojima  1   2 , Kosuke Kuroda  3 , Makiko Tani  1 , Tomoyuki Kanazawa  1 , Kazuyoshi Shimizu  1 , Jota Maki  4 , Hisashi Masuyama  4 , Hiroshi Morimatsu  1
Affiliations

Therapeutic plasma exchange in postpartum HELLP syndrome: a case report

Nana Kojima et al. JA Clin Rep. .

Abstract

Background: Postpartum hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome is more difficult to treat than HELLP syndrome during pregnancy. We describe a case of postpartum HELLP syndrome that responded to plasma exchange (PE) therapy.

Case presentation: A 30-year-old primipara woman was hospitalized for gestational hypertension at 33 weeks of gestation and underwent an emergent cesarean section at 36 weeks and 6 days of gestation due to rapidly progressing pulmonary edema. After delivery, liver dysfunction and a rapid decrease in platelet count were observed, and the patient was diagnosed with severe HELLP syndrome. She experienced multiple organ failure despite intensive care, and PE therapy was initiated. Her general condition dramatically stabilized within a few hours of PE therapy.

Conclusion: It is controversial whether PE therapy should be used primarily in the management of HELLP syndrome, but early initiation of PE therapy could be effective for severe HELLP syndrome.

Keywords: HELLP syndrome; Plasma exchange therapy; Postpartum; Thrombotic microangiopathy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Changes in laboratory findings and events. After delivery, acute elevations in AST and LDH and a rapid decrease in platelet count were observed and continued to worsen. PE therapy was performed, and the laboratory findings improved. AST, aspartate aminotransferase (IU/L); LDH, lactate dehydrogenase (IU/L); Plt, platelet count (/L); PE, plasma exchange; CHDF, continuous hemodiafiltration; POD, postoperative day
See this image and copyright information in PMC

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