Abstract
To assess and compare the severity of hematological, renal and liver manifestation, the blood PLGF and sFlt1 levels in patinets with HELLP-syndrome, PE and aHUS, and evaluate the association markers with the severity of clinical manifestations. Women with PE (Gr1),HELLP (Gr2), P-aHUS (Gr3), PE and with normal pregnancies were recruited for the retrospective study from September 1, 2013 to December 31,2017. Gr3 had a poor outcome and most severe course. Based on clinical findings in P-aHUS, we propose a similar mechanism for a pathogenetic role of complement in HELLP. PE is only trigger or complement-activating condition for development HELLP-syndrome. Depending on the triggering stimuli and vascular bed involved, aHUS or the HELLP syndrome may develop. There were more severe clinical manifestations of renal impairment in all pts with HELLP and PaHUS as compared to women with PE and control gr. The sFlt-1 level was significantly higher in pts with PE as compared with HELLP and HELLP-onset aHUS. Less increased ratio of sFlt-1/ PlGF in gr.1 may confirm that PE is only complement amplifying factor to HELLP-development.
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