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Saudi Journal of Kidney Diseases and Transplantation
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LETTER TO EDITOR Table of Contents   
Year : 1999  |  Volume : 10  |  Issue : 2  |  Page : 188
Acute Renal Failure in HELLP Syndrome

Consultant Nephrologist, Arar Central Hospital, North Zone, Arar, Saudi Arabia

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How to cite this article:
Bhat A, Ibrahim AE. Acute Renal Failure in HELLP Syndrome. Saudi J Kidney Dis Transpl 1999;10:188

How to cite this URL:
Bhat A, Ibrahim AE. Acute Renal Failure in HELLP Syndrome. Saudi J Kidney Dis Transpl [serial online] 1999 [cited 2022 Aug 15];10:188. Available from: https://www.sjkdt.org/text.asp?1999/10/2/188/37230
To the Editor:

It is with great interest that we read the two articles on subject of acute renal failure (ARF) and hemodialysis elevated live enzyme low platelet syndrome (HELLP) in your Journal. One article was by M.A> Abbade [1] and second by Iftikhar A. Sheik. [2] We would like to share our experience similar case. A 35 years old Palestinian woman Gravida 7 Para 5 who had 33 weeks of pregnancy with transverse position of fetus and underwent a cesarean section. This was followed by a progressive decrease in urine output and complaint of dizziness. She had neither history of significant blood loss nor received any blood transfusion. On exami­nation she was conscious, oriented with heart rate of 92/min, B/P -140/90 mmHg, and Jugular venous pressure was not raised. She had Jaundice, pedal edema, and there were few ecchymotic patches in the skin of her trunk.

Her hemoglobin level was 96 gm/L; total leukocyte count was 14x10 3 /µL, platelets count was 80x103 µ and reticulocyte count was 8%. Her bilirubin was 128 mmol/I; Serum creatinine 559umol/I, Calcium 1.9 mmol/L and Albumin 27 g/L. There was increased urobilonogen in urine and 24 hours urinary protein was 0.5 gm. HbsAg and HCV and HIV antibodies were negative. Her partial thromboplastin time (PTT) was prolonged up to 90 seconds but prothrombin time was normal. Prolonged PTT, thrombocytopenia and ecchymotic patches suggested early disseminated intravascular coagulation (DIC). Management was conservative including two times blood transfusions. Urine output, hemoglobin and platelet count increased gradually to normal. Decrease of the blood levels of bilirubin, liver enzymes, urea and creatinine started from the second week of illness.

On follow up one month later the patient had normal liver and renal functions. This further supports the view that ARF in HELLP syndrome can be managed conser­vatively and may not need dialysis.

   References Top

1.Sheik IA, Shaheen FAM. Acute Renal Failure and HELLP syndrome: a single centers experience. Saudi J Kidney J Kidney Dis Transplant 1998;9(3):290-3.  Back to cited text no. 1    
2.Abbade MA, Mohamed AO, Bernieh BO. Acute renal failure in a patient with HELLP syndrome, developing in postpartum period. Saudi J Kidney Dis Transplant 1997; 8(4):433-5.  Back to cited text no. 2    

Correspondence Address:
Abdulwahid Bhat
Consultant Nephrologist, Arar Central Hospital, North Zone, Arar
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

PMID: 18212433

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