thromboxane-a2 and Anemia--Hemolytic

A severe case of preeclampsia with Hellp Syndrome is reported. Clinical findings, laboratory abnormalities and pathogenesis, were discussed. We concluded that severe preeclampsia and Hellp Syndrome are not different diseases, but the natural course of preeclampsia per se.

Topics: Adult; Anemia, Hemolytic; Anticonvulsants; Antihypertensive Agents; Cesarean Section; Combined Modality Therapy; Epoprostenol; Female; Humans; Incidence; Liver Diseases; Pre-Eclampsia; Pregnancy; Syndrome; Thrombocytopenia; Thromboxane A2; Vasoconstriction

Thrombotic thrombocytopenic purpura is an uncommon, life-threatening disorder that affects older children and adolescents as well as adults. A variety of theories have been proposed to explain its clinical and pathologic manifestations, but the pathophysiology remains poorly understood. It is not even clear whether this disease primarily affects the endothelial cell, the platelet, or both. Most patients have no discernable predisposition to this disease. Our failure to define the pathophysiology of thrombotic thrombocytopenic purpura adequately has hampered our ability to design rational and consistently successful therapy. The present knowledge of this pathophysiology is discussed in detail. The high mortality of this disease necessitates rapid diagnosis so that therapy can be instituted as quickly as possible. The clinical manifestations and diagnostic criteria of thrombotic thrombocytopenic purpura are therefore reviewed.

Topics: Anemia, Hemolytic; Blood Coagulation Factors; Blood Platelets; Child; Diagnosis, Differential; Endothelium; Epoprostenol; Factor VIII; Female; Fever; Fibrinolytic Agents; Hemolytic-Uremic Syndrome; Humans; Kidney Diseases; Male; Neurologic Manifestations; Platelet Activating Factor; Purpura; Purpura, Thrombotic Thrombocytopenic; Thromboxane A2

1. The lack of a general agreement on the definition of PE makes the interpretation of laboratory findings in different series of these patients difficult. 2. Thrombocytopenia is the most common hemostatic abnormality in patients with PE and is caused by platelet consumption. 3. There is little concrete evidence that thrombin mediates the thrombocytopenia in most of these patients. 4. Immune mechanisms or severe vasospasm with resultant endothelial damage may contribute to the thrombocytopenia in some patients.

Topics: Anemia, Hemolytic; Disseminated Intravascular Coagulation; Eclampsia; Epoprostenol; Factor VIII; Female; Fibrin; Fibrin Fibrinogen Degradation Products; Fibrinogen; Fibrinopeptide A; Humans; Hypertension; Platelet Count; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Hematologic; Thrombin; Thrombocytopenia; Thromboxane A2