Спорные вопросы ведения пациенток с HELLP-синдромом

Abstract

Aim. To demonstrate a clinical case of HELLP syndrome with renal damage that required the use of therapeutic plasma exchange and to review the literature data on the treatment of this condition. Key points. A clinical case of HELLP syndrome with renal dysfunction in a 19-year-old first-pregnant woman is described. The rapid development of the disease in the postpartum period required differential diagnosis of HELLP-syndrome with other types of thrombotic microangiopathy. Therapeutic plasma exchange was used in treatment. Conclusion. Differential diagnosis of HELLP-syndrome and obstetric thrombotic microangiopathy attracts the interest of obstetrician-gynecologists. In patient G. the differential diagnosis was carried out in full, according to the current clinical recommendations. Thus, effective therapy of HELLP-syndrome is possible with simultaneous influence on all pathogenetic links — activation of inflammation processes, endothelial dysfunction and coagulopathy. Keywords: severe preeclampsia, HELLP-syndrome, thrombotic microangiopathy, plasma exchange.