Severe Preeclampsia with Fulminant and Extreme Elevation of Aspartate Aminotransferase and Lactate Dehydrogenase Levels: High Risk for Maternal Death
ABSTRACT We report a subgroup of patients with fulminant hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome, manifesting extreme elevation of aspartate aminotransferase (AST; SGOT) and lactate dehydrogenase (LDH) levels and abnormal mental status. These gravidas are at high risk...
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| Veröffentlicht in: | American journal of perinatology 1995-09, Vol.12 (5), p.310-313 |
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| container_title | American journal of perinatology |
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| creator | Catanzarite, Val A. Steinberg, Steve M. Mosley, Coleman A. Landers, Charles F. Cousins, Larry M. Schneider, Jack M. |
| description | ABSTRACT
We report a subgroup of patients with fulminant hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome, manifesting extreme elevation of aspartate aminotransferase (AST; SGOT) and lactate dehydrogenase (LDH) levels and abnormal mental status. These gravidas are at high risk for mortality. Only four patients treated by the authors over a 10-year period have had AST more than 2000 IU/L and LDH more than 3000 IU/L in the HELLP syndrome. This report is based on retrospective chart review. All patients manifested disordered mental status, jaundice, intense hemolysis, and extreme hypertension. One patient had developed multiple organ system failure, was moribund at initial perinatal consultation, and died. The three others were treated with aggressive afterload reduction and plasma infusion or plasmapheresis; two survived. Fulminant HELLP syndrome occurs rarely, but marks a group of patients at high risk for mortality. Optimal therapy is unclear; early intervention, including afterload reduction, volume expansion, and consideration of plasma infusions or plasmapheresis, is recommended. |
| doi_str_mv | 10.1055/s-2007-994482 |
| format | Article |
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We report a subgroup of patients with fulminant hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome, manifesting extreme elevation of aspartate aminotransferase (AST; SGOT) and lactate dehydrogenase (LDH) levels and abnormal mental status. These gravidas are at high risk for mortality. Only four patients treated by the authors over a 10-year period have had AST more than 2000 IU/L and LDH more than 3000 IU/L in the HELLP syndrome. This report is based on retrospective chart review. All patients manifested disordered mental status, jaundice, intense hemolysis, and extreme hypertension. One patient had developed multiple organ system failure, was moribund at initial perinatal consultation, and died. The three others were treated with aggressive afterload reduction and plasma infusion or plasmapheresis; two survived. Fulminant HELLP syndrome occurs rarely, but marks a group of patients at high risk for mortality. Optimal therapy is unclear; early intervention, including afterload reduction, volume expansion, and consideration of plasma infusions or plasmapheresis, is recommended.</description><identifier>ISSN: 0735-1631</identifier><identifier>EISSN: 1098-8785</identifier><identifier>DOI: 10.1055/s-2007-994482</identifier><identifier>PMID: 8540929</identifier><identifier>CODEN: AJPEEK</identifier><language>eng</language><publisher>New York, NY: Thieme</publisher><subject>Adult ; Aspartate Aminotransferases - blood ; Biological and medical sciences ; Diagnosis, Differential ; Diseases of mother, fetus and pregnancy ; Fatal Outcome ; Female ; Gynecology. Andrology. Obstetrics ; HELLP Syndrome - complications ; HELLP Syndrome - diagnosis ; HELLP Syndrome - enzymology ; HELLP Syndrome - therapy ; Humans ; L-Lactate Dehydrogenase - blood ; Medical sciences ; Multiple Organ Failure - etiology ; ORIGINAL ARTICLE ; Pre-Eclampsia - diagnosis ; Pre-Eclampsia - enzymology ; Pregnancy ; Pregnancy. Fetus. Placenta ; Risk Factors</subject><ispartof>American journal of perinatology, 1995-09, Vol.12 (5), p.310-313</ispartof><rights>1995 by Thieme Medical Publishers, Inc.</rights><rights>1995 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c354t-b553c085c8b4a4f469665e1a0d3d75cfb5faef46b106f7085effe9feff91e7a83</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-2007-994482.pdf$$EPDF$$P50$$Gthieme$$H</linktopdf><linktohtml>$$Uhttps://www.thieme-connect.de/products/ejournals/html/10.1055/s-2007-994482$$EHTML$$P50$$Gthieme$$H</linktohtml><link.rule.ids>314,780,784,3017,3018,27924,27925,54559,54560</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3692374$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8540929$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Catanzarite, Val A.</creatorcontrib><creatorcontrib>Steinberg, Steve M.</creatorcontrib><creatorcontrib>Mosley, Coleman A.</creatorcontrib><creatorcontrib>Landers, Charles F.</creatorcontrib><creatorcontrib>Cousins, Larry M.</creatorcontrib><creatorcontrib>Schneider, Jack M.</creatorcontrib><title>Severe Preeclampsia with Fulminant and Extreme Elevation of Aspartate Aminotransferase and Lactate Dehydrogenase Levels: High Risk for Maternal Death</title><title>American journal of perinatology</title><addtitle>Amer J Perinatol</addtitle><description>ABSTRACT
We report a subgroup of patients with fulminant hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome, manifesting extreme elevation of aspartate aminotransferase (AST; SGOT) and lactate dehydrogenase (LDH) levels and abnormal mental status. These gravidas are at high risk for mortality. Only four patients treated by the authors over a 10-year period have had AST more than 2000 IU/L and LDH more than 3000 IU/L in the HELLP syndrome. This report is based on retrospective chart review. All patients manifested disordered mental status, jaundice, intense hemolysis, and extreme hypertension. One patient had developed multiple organ system failure, was moribund at initial perinatal consultation, and died. The three others were treated with aggressive afterload reduction and plasma infusion or plasmapheresis; two survived. Fulminant HELLP syndrome occurs rarely, but marks a group of patients at high risk for mortality. Optimal therapy is unclear; early intervention, including afterload reduction, volume expansion, and consideration of plasma infusions or plasmapheresis, is recommended.</description><subject>Adult</subject><subject>Aspartate Aminotransferases - blood</subject><subject>Biological and medical sciences</subject><subject>Diagnosis, Differential</subject><subject>Diseases of mother, fetus and pregnancy</subject><subject>Fatal Outcome</subject><subject>Female</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>HELLP Syndrome - complications</subject><subject>HELLP Syndrome - diagnosis</subject><subject>HELLP Syndrome - enzymology</subject><subject>HELLP Syndrome - therapy</subject><subject>Humans</subject><subject>L-Lactate Dehydrogenase - blood</subject><subject>Medical sciences</subject><subject>Multiple Organ Failure - etiology</subject><subject>ORIGINAL ARTICLE</subject><subject>Pre-Eclampsia - diagnosis</subject><subject>Pre-Eclampsia - enzymology</subject><subject>Pregnancy</subject><subject>Pregnancy. Fetus. Placenta</subject><subject>Risk Factors</subject><issn>0735-1631</issn><issn>1098-8785</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU9v1DAQxS0EKtvCkSOSD4hTA3YSJw63VdlSpEUg_pyjiTNuXJJ48TiFfhC-L97uqjd8GEvzfjMjvcfYCyneSKHUW8pyIeqsacpS54_YSopGZ7rW6jFbibpQmawK-ZSdEt0IIXMt9Ak70aoUTd6s2N9veIsB-ZeAaEaYduSA_3Zx4JfLOLkZ5shh7vnmTww4Id-MeAvR-Zl7y9e0gxAhIl8n1McAM1kMQHg_swVzL77H4a4P_hrnvbJNB0d6x6_c9cC_OvrJrQ_8UwLDDGOCIQ7P2BMLI-Hz43_Gflxuvl9cZdvPHz5erLeZKVQZs06pwgitjO5KKG1ZNVWlUILoi75WxnbKAqZ2J0Vl6wSitdjYVBuJNejijL0-7N0F_2tBiu3kyOA4wox-obZOLxdVkcDsAJrgiQLadhfcBOGulaLdx9BSu4-hPcSQ-JfHxUs3Yf9AH31P-qujDmRgtMk54-gBK6omL-oyYecHLA4uud_e-GVvEv3n6j-SD6B5</recordid><startdate>19950901</startdate><enddate>19950901</enddate><creator>Catanzarite, Val A.</creator><creator>Steinberg, Steve M.</creator><creator>Mosley, Coleman A.</creator><creator>Landers, Charles F.</creator><creator>Cousins, Larry M.</creator><creator>Schneider, Jack M.</creator><general>Thieme</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19950901</creationdate><title>Severe Preeclampsia with Fulminant and Extreme Elevation of Aspartate Aminotransferase and Lactate Dehydrogenase Levels: High Risk for Maternal Death</title><author>Catanzarite, Val A. ; Steinberg, Steve M. ; Mosley, Coleman A. ; Landers, Charles F. ; Cousins, Larry M. ; Schneider, Jack M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c354t-b553c085c8b4a4f469665e1a0d3d75cfb5faef46b106f7085effe9feff91e7a83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Adult</topic><topic>Aspartate Aminotransferases - blood</topic><topic>Biological and medical sciences</topic><topic>Diagnosis, Differential</topic><topic>Diseases of mother, fetus and pregnancy</topic><topic>Fatal Outcome</topic><topic>Female</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>HELLP Syndrome - complications</topic><topic>HELLP Syndrome - diagnosis</topic><topic>HELLP Syndrome - enzymology</topic><topic>HELLP Syndrome - therapy</topic><topic>Humans</topic><topic>L-Lactate Dehydrogenase - blood</topic><topic>Medical sciences</topic><topic>Multiple Organ Failure - etiology</topic><topic>ORIGINAL ARTICLE</topic><topic>Pre-Eclampsia - diagnosis</topic><topic>Pre-Eclampsia - enzymology</topic><topic>Pregnancy</topic><topic>Pregnancy. Fetus. Placenta</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Catanzarite, Val A.</creatorcontrib><creatorcontrib>Steinberg, Steve M.</creatorcontrib><creatorcontrib>Mosley, Coleman A.</creatorcontrib><creatorcontrib>Landers, Charles F.</creatorcontrib><creatorcontrib>Cousins, Larry M.</creatorcontrib><creatorcontrib>Schneider, Jack M.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of perinatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Catanzarite, Val A.</au><au>Steinberg, Steve M.</au><au>Mosley, Coleman A.</au><au>Landers, Charles F.</au><au>Cousins, Larry M.</au><au>Schneider, Jack M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Severe Preeclampsia with Fulminant and Extreme Elevation of Aspartate Aminotransferase and Lactate Dehydrogenase Levels: High Risk for Maternal Death</atitle><jtitle>American journal of perinatology</jtitle><addtitle>Amer J Perinatol</addtitle><date>1995-09-01</date><risdate>1995</risdate><volume>12</volume><issue>5</issue><spage>310</spage><epage>313</epage><pages>310-313</pages><issn>0735-1631</issn><eissn>1098-8785</eissn><coden>AJPEEK</coden><abstract>ABSTRACT
We report a subgroup of patients with fulminant hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome, manifesting extreme elevation of aspartate aminotransferase (AST; SGOT) and lactate dehydrogenase (LDH) levels and abnormal mental status. These gravidas are at high risk for mortality. Only four patients treated by the authors over a 10-year period have had AST more than 2000 IU/L and LDH more than 3000 IU/L in the HELLP syndrome. This report is based on retrospective chart review. All patients manifested disordered mental status, jaundice, intense hemolysis, and extreme hypertension. One patient had developed multiple organ system failure, was moribund at initial perinatal consultation, and died. The three others were treated with aggressive afterload reduction and plasma infusion or plasmapheresis; two survived. Fulminant HELLP syndrome occurs rarely, but marks a group of patients at high risk for mortality. Optimal therapy is unclear; early intervention, including afterload reduction, volume expansion, and consideration of plasma infusions or plasmapheresis, is recommended.</abstract><cop>New York, NY</cop><pub>Thieme</pub><pmid>8540929</pmid><doi>10.1055/s-2007-994482</doi><tpages>4</tpages></addata></record> |
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| ispartof | American journal of perinatology, 1995-09, Vol.12 (5), p.310-313 |
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| subjects | Adult Aspartate Aminotransferases - blood Biological and medical sciences Diagnosis, Differential Diseases of mother, fetus and pregnancy Fatal Outcome Female Gynecology. Andrology. Obstetrics HELLP Syndrome - complications HELLP Syndrome - diagnosis HELLP Syndrome - enzymology HELLP Syndrome - therapy Humans L-Lactate Dehydrogenase - blood Medical sciences Multiple Organ Failure - etiology ORIGINAL ARTICLE Pre-Eclampsia - diagnosis Pre-Eclampsia - enzymology Pregnancy Pregnancy. Fetus. Placenta Risk Factors |
| title | Severe Preeclampsia with Fulminant and Extreme Elevation of Aspartate Aminotransferase and Lactate Dehydrogenase Levels: High Risk for Maternal Death |
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