Title :

Is the presence of antiphospholipid antibodies a poor prognostic factor for patients with hellp syndrome?

Author(s) :

Pecourt, Mathilde [Auteur]
Centre hospitalier Saint-Joseph [Paris]
Yelnik, Cecile [Auteur]
Centre National de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France [CeRAINO]
Ghesquière, Louise [Auteur]
Service de Gynécologie - Obstétrique [Lille]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Drumez, Elodie [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Cailliau, Emeline [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Hachulla, Eric [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Centre National de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France [CeRAINO]
Debarge, Veronique [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Morel, Nathalie [Auteur]
Centre for Research in Epidemiology and Statistics | Centre de Recherche Épidémiologie et Statistiques [CRESS (U1153 / UMR_A 1125)]
Hôpital Cochin [AP-HP]
Le Guern, Véronique [Auteur]
Service de médecine interne et centre de référence des maladies rares [CHU Cochin]
Centre for Research in Epidemiology and Statistics | Centre de Recherche Épidémiologie et Statistiques [CRESS (U1153 / UMR_A 1125)]
Hôpital Cochin [AP-HP]
Garabedian, Charles [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Costedoat-Chalumeau, Nathalie [Auteur]
Service de médecine interne et centre de référence des maladies rares [CHU Cochin]
Centre for Research in Epidemiology and Statistics | Centre de Recherche Épidémiologie et Statistiques [CRESS (U1153 / UMR_A 1125)]
Hôpital Cochin [AP-HP]
Lambert, Marc [Auteur]
Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement (RID-AGE) - U1167
Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement (RID-AGE) - U1167

Journal title :

American Journal of Obstetrics and Gynecology

Abbreviated title :

Am J Obstet Gynecol

Publication date :

2021-04-01

ISSN :

1097-6868

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BACKGROUND: The characteristics of antiphospholipid syndrome-associated hemolysis, elevated liver enzymes, and low platelet count syndrome are poorly described, likely because of the low frequency of this combination of ...
Show more >BACKGROUND: The characteristics of antiphospholipid syndrome-associated hemolysis, elevated liver enzymes, and low platelet count syndrome are poorly described, likely because of the low frequency of this combination of syndromes. OBJECTIVE: This study aimed to compare the characteristics and prognosis of hemolysis, elevated liver enzymes, and low platelet count syndrome in patients with and without antiphospholipid syndrome. METHODS: In this multicenter, case-control study, adult women diagnosed with hemolysis, elevated liver enzymes, and low platelet count syndrome before 34 weeks' gestation and who were also tested for antiphospholipid antibodies according to international diagnostic recommendations were included. Cases labeled "HELLP-APS+" were defined as patients who fulfilled the international classification criteria for antiphospholipid syndrome; they were retrospectively recruited by screening the 672 patients with antiphospholipid syndrome in our antiphospholipid syndrome database. Control cases labeled "HELLP-APS-" were defined as patients who did not fulfill the criteria for antiphospholipid syndrome; they were retrospectively recruited from our hospital admission database. RESULTS: Overall, 71 patients were included (mean age, 30±5 years), with 23 patients in the hemolysis, elevated liver enzymes, and low platelet count syndrome with antiphospholipid syndrome group and 48 patients in the hemolysis, elevated liver enzymes, and low platelet count syndrome without antiphospholipid syndrome group. The live birth rate was significantly lower for patients with hemolysis, elevated liver enzymes, and low platelet count with antiphospholipid syndrome than for those with hemolysis, elevated liver enzymes, and low platelet count syndrome without antiphospholipid syndrome (43.5% vs 89.4%; P<.001). The patients with hemolysis, elevated liver enzymes, and low platelet count syndrome with antiphospholipid syndrome gave birth prematurely more often than the patients without antiphospholipid syndrome (24 weeks' gestation; 22.0-28.0 weeks vs 30 weeks' gestation; 27.0-33.0 weeks; P<.001). Among the patients with hemolysis, elevated liver enzymes, and low platelet count syndrome with antiphospholipid syndrome, 39% required an induced abortion owing to hemolysis, elevated liver enzymes, and low platelet count syndrome severity vs 8.5% of the patients with hemolysis, elevated liver enzymes, and low platelet count syndrome without antiphospholipid syndrome (P=.006). The intensive care unit admission rate was 61.9% in patients with hemolysis, elevated liver enzymes, and low platelet count syndrome with antiphospholipid syndrome, which was significantly higher than the rate of 27.7% in patients with hemolysis, elevated liver enzymes, and low platelet count syndrome without antiphospholipid syndrome (P=.007). None of the mothers died. CONCLUSIONS: Our results suggest that the presence of antiphospholipid syndrome is a poor prognostic factor for both the mother and fetus in patients with hemolysis, elevated liver enzymes, and low platelet count syndrome.Show less >

Language :

Anglais

Peer reviewed article :

Oui

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Inserm
Institut Pasteur de Lille
Université de Lille

Collections :

• Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement (RID-AGE) - U1167
• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2021-07-06T12:44:30Z
2024-03-04T13:59:30Z