High beta-amyloid(1–40) cerebrospinal fluid concentrations precede increase of serum biomarkers in a case with severe HELLP syndrome

Beta-amyloid peptides and tau protein concentrations were analysed at second and third trimester pregnancy in cerebrospinal fluid in a 27-year old woman who developed severe HELLP (Hemolysis, Elevated Liver enzymes and Low Platelets) syndrome. Contrary to a healthy pregnant control the beta-amyloid(1–40) load was much higher and the ratios beta-amyloid peptides(1–42/1-40) and phospho-tau/tau had increased before delivery. We observed that in early HELLP syndrome increased beta-amyloid levels preceded vascular biomarker changes. We conclude that high levels of beta-amyloid(1–40) in the second trimester of pregnancy might reflect pathologic maternal brain changes that go along with pathological changes in the materno-feto-placental unit. [Display omitted] •Second trimester beta-amyloid(1–42/1-40) ratio in CSF is low in HELLP syndrome.•Beta-amyloid(1–40) in CSF is high during HELLP syndrome.•Phospho-tau/tau ratio does not differ between HELLP syndrome case and control.•High CSF beta-amyloid(1–40) in HELLP precedes increase of sFlt1/PlGF.•Pathologic brain changes occur early in the pathophysiology of HELLP syndrome.