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PRACA PRZEGLĄDOWA
Zespół HELLP: powikłanie czy nowy zespół autoimmunologiczny?
 
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Data publikacji online: 30-11-2014
 
 
Reumatologia 2014;52(6):377-383
 
SŁOWA KLUCZOWE
STRESZCZENIE
Zespół HELLP (hemolysis, elevated liver enzymes, low platelets) jest schorzeniem występującym u kobiet w ciąży. Składają się na niego następujące objawy: hemoliza ze zwiększonym stężeniem dehydrogenazy mleczanowej, zwiększonym stężeniem enzymów wątrobowych oraz obniżona liczba płytek krwi. Zespół HELLP uznawany jest za ciężką postać zaburzeń nadciśnieniowych wywołanych ciążą, do których należą także stan przedrzucawkowy oraz rzucawka. Objawy zaburzeń zaczynają pojawiać się od 20. tygodnia ciąży. Wszystkie te choroby mają charakter wieloukładowy, specyficzny dla ciąży i wiążą się ze wzrostem ciśnienia krwi oraz podwyższoną chorobowością/śmiertelnością noworodków i matek. Badania obserwacyjne wskazują, że leczenie zespołu HELLP lekami steroidowymi może przynieść poprawę parametrów hematologicznych i biochemicznych u matek, a także poprawę rokowania u noworodków. Celem niniejszej pracy jest wykazanie, że zespół HELLP można uznać za niezależne schorzenie autoimmunologiczne. Biomarkery immunologiczne mogą być użytecznym narzędziem usprawniającym diagnostykę i leczenie kobiet z zespołem HELLP dzięki określeniu etiologii leżącej u podłoża tego zespołu.
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