Laboratory and clinical characteristics of patients diagnosed with HELLP syndrome due to microangiopathic hemolytic anemia and/or thrombocytopenia

Abstract

INTRODUCTION: We aimed to present the pregnant patients who were consulted with hematologists for microangiopathic hemolytic anemia and/or thrombocytopenia and were diagnosed HELLP syndrome. METHODS: A total of 32 patients, who were diagnosed with HELLP syndrome, were included in this study. Patients with other microangiopathic hemolytic anemia, including pre-eclampsia, eclampsia, thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, disseminated intravascular coagulation etc. were excluded. RESULTS: The median age of all patients was 30.45+-16.22 (18-52) years. According to the Mississippi classification; 12 patients(37.5%) were in class 1 while 15 patients(46.9%) were in class 2, and there was acute renal failure in 4 patients(33.3%) in class 1 and 3 patients(20%) in class 2. There was no acute renal failure present in the class 3 including a total of 5 patients(15.6%). There was renal failure in 6(42.9%) of 14 patients(43.7%) with HELLP syndrome, whose hemoglobin value was less than or equal to 8 gr/dl. In patients with HELLP syndrome, the renal failure risk of those whose hemoglobin value was less than or equal to 8 gr/dl was significantly higher than those whose hemoglobin value was greater than 8 gr/dl(OR: 12.75, p=0.0285). DISCUSSION AND CONCLUSION: The mechanism of occurrence of HELLP syndrome is not clear and have many overlapping clinical aspects with the other thrombotic microangiopathic syndromes. Renal failure is a complication of HELLP syndrome. The most associated cases with renal failure are the presence of DIC and severe anemia in HELLP syndrome. The hemoglobin value of less than 8 gr/dl is a significant risk factor for renal failure in HELLP syndrome.

Keywords

• microangiopathic hemolytic anemia
• thrombocytopenia
• hellp syndrome
• renal failure