Saturday March 11, 2006
Triad of HELLP Syndrome
HELLP syndrome is a unique variant of preeclampsia and may manifest even before clinical signs of preeclampsia. Triad or criteria and term "HELLP" syndrome was first designated by Louis Weinstein, M.D. in 1982 in American Journal of Obstet. Gynecol. 1, and is as follows:
1. Hemolysis: Abnormal blood smear - Elevated Bilirubin >1.2 mg/dl
2. Elevated liver enzymes - with SGOT >72 UI / L (but has been mentioned as low as 40) and LDH >600 UI/L
3. Low Platelets: Less than 100. Please note that platelet's cutoff of 100 is debatable and another classification for this syndrome called Mississippi Classification used level less than 150. Read reference # 2 which may need subscription.
See impressive slide presentation here on HELLP Syndrome from JOHN ESSIEN M.D. and coll. from HOSPITAL GINECOBSTÉTRICO PROVINCIAL, CAMAGÜEY., CUBA - (its a power point presentation)
Previous related pearl: IV Magnesium (Mg) infusion
References:
1.Syndrome of hemolysis, elevated liver enzymes, and low platelet count: a severe consequence of hypertension in pregnancy. Weinstein L. Am J Obstet Gynecol.1982 Jan 15;142(2):159-67
2. Prevention of Eclampsia - letters to editor, NEJM, May 23, 2003, Volume 348:2154-2155
