Acute liver failure and HELLP syndrome: A clinical case and literature review - 20/04/21

Doi : 10.1016/j.clinre.2020.07.005

Alessandra Mazzola ^a,^⁎ , Bianca Magro ^a,^b, Fabiano Perdigao ^c, Fréderic Charlotte ^d, Muhammad Atif ^e, Claire Goumard ^c,^f,^g, Olivier Scatton ^c,^f,^g, Filomena Conti ^a,^f,^g
^a APHP, Unité Médicale de Transplantation Hépatique Hôpital Pitié Salpêtrière, Boulevard de l’Hôpital 47-83, 75013 Paris, France
^b Di.BIMIS Gastroenterology, University of Palermo, Piazza delle Cliniche N2, 90100 Palermo, Italy
^c Liver Transplant Unit, APHP, Unité de Chirurgie Hépatobiliaire et Transplantation hépatique, Hôpital Pitié Salpêtrière, Boulevard de l’Hôpital 47-83, 75013 Paris, France
^d APHP, Service d’Anatomopathologie, Hôpital Pitié Salpêtrière, Boulevard de l’Hôpital 47-83, 75013 Paris, France
^e APHP, Centre d’immunologie et maladies infectieuses, Sorbonne Université, Paris, France
^f Sorbonne Université, INSERM, Institute of Cardiometabolisme and Nutrition (ICAN), Paris, France
^g Sorbonne Université, INSERM, Centre de recherche Saint-Antoine (CRSA), Paris, France

^⁎Corresponding author.

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Summary

Background

HELLP syndrome is a pregnancy-related liver disease associated with increased maternal and foetal mortality. In rare cases, it can lead to the development of a subcapsular hepatic haematoma as well as its rupture. This rupture is life-threatening if not urgently treated.

Method

We describe a clinical case of HELLP syndrome involving a ruptured subcapsular liver haematoma and contextualise this with a literature overview.

Clinical case

A 39-year-old woman of 40 weeks’ gestation presented to her local Emergency Department with symptoms and serology classically associated with HELLP syndrome. However, she clinically deteriorated and developed a ruptured subcapsular haematoma. She underwent an emergency Caesarean section at her initial hospital. Upon clinical stabilisation, she was transferred to our transplant unit for an urgent liver transplant.

Conclusion

LT is a life-saving procedure for patients with acute liver failure secondary to HELLP syndrome. These patients should be immediately referred to a high-volume transplant centre.

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Abbreviations : HELLP

Keywords : HELLP syndrome, Haematoma, Liver necrosis, Liver transplantation

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Introduction

Clinical case

Discussion

Symptoms and diagnosis

Treatment and outcomes

Conflict of interest

Esportazione

Vol 45 - N° 2

Articolo 101498- Marzo 2021 Ritorno al numero

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Acute liver failure and HELLP syndrome: A clinical case and literature review - 20/04/21

Summary

Background

Method

Clinical case

Conclusion

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