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Revista Salud Uninorte
Print version ISSN 0120-5552On-line version ISSN 2011-7531
Abstract
RIVAS PERDOMO, Edgar E. and MENDIVIL CIODARO, César. Hellp Syndrome: Review. Salud, Barranquilla [online]. 2011, vol.27, n.2, pp.259-274. ISSN 0120-5552.
A HELLP syndrome review is presented, with greater emphasis on new theories that seek to explain the pathophysiology and management recommendations. The syndrome is characterized by microvascular endothelial damage. However, the pathophysiology of the syndrome is not yet well defined. There is a growing interest in inflammatory cytokines, genetic and environmental factors in the pathogenesis of the same. To consider it a diffuse Microangiopathy pregnancy pays attention to the angiogenic factors and could be explained by the imbalance of the circulating angiogénics, characterized by high circulating levels of tirosincinasa factors type 1 soluble fins and endoglin and other angiogenic factors and lower circulating levels of placental growth factor and vascular endothelial growth factor. The systemic impact is of such magnitude that serum levels of heat shock proteins are significantly higher in patients with the HELLP syndrome. The diagnosis necessitates the clinical presentation and studies showing the alteration of the parameters that characterize it. Alternatives for everyday exams as the low concentration of which can be used for the diagnosis of hemolysis and is the preference for the same marker haptoglobin are presented. Glutathione S-transferase-al plasma could be a more sensitive transaminases to diagnosis early liver damage. Finally, recommendations are presented for clinical management of the disease, including the need for interdisciplinary management in an intensive care unit.
Keywords : Syndrome Hellp; angiogenics factors; endoglinas; haptoglobin; glutathione s-transferase-al.