Pseudo-HELLP syndrome par carence en folates et/ou en vitamine B12: à propos d'un cas

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Abstract

Plusieurs pathologies médicales peuvent interférer avec la grossesse et mimer le tableau biologique de HELLP syndrome. L’évolution naturelle de ce syndrome est d'une particulière gravité pour la mère et le fœtus, il convient d’éliminer rapidement les autres diagnostics afin d’éviter une extraction fœtale prématurée injustifiée. Nous rapportons le cas d'une parturiente qui s'est présentée avec un tableau évocateur d'un HELLP syndrome, rapporté finalement à une carence en folates et en vitamine B12.

Most cited references 6

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Maternal morbidity and mortality in 442 pregnancies with hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome)

Rola Salama, Samuel R Friedman, I Usta … (1993)

Our purpose was to describe the incidence and effects of serious obstetric complications on maternal outcome in pregnancies complicated by HELLP syndrome. A prospective cohort study was performed on 442 pregnancies with HELLP syndrome managed at this center from August 1977 through July 1992. Of 437 women who had 442 pregnancies with HELLP syndrome; 309 (70%) of the cases occurred ante partum and 133 (30%) post partum; 149 (11%) developed at < 27 weeks and 80 (18%) at term. Maternal mortality was 1.1% (five patients). Serious maternal morbidity included disseminated intravascular coagulation (21%), abruptio placentae (16%), acute renal failure (7.7%), pulmonary edema (6%), subcapsular liver hematoma (0.9%), and retinal detachment (0.9%). Fifty-five percent of patients required transfusions with blood or blood products, and 2% required laparotomies for major intraabdominal bleeding. Abruptio placentae was strongly correlated with the development of disseminated intravascular coagulation (p < 0.0001), acute renal failure (p < 0.001), and pulmonary edema (p < 0.01). Moreover, there was a strong association between pulmonary edema and acute renal failure (p < 0.0001). There were no differences in laboratory findings between HELLP syndrome before and after delivery; however, women with postpartum HELLP syndrome had significantly higher incidences of pulmonary edema and renal failure. HELLP syndrome is associated with serious maternal morbidity, especially when it arises in the postpartum period.

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[Update of clinical findings in cobalamin deficiency: personal data and review of the literature].

F Maloisel, L Federici, S Affenberger … (2007)

During last decades, several progresses have been made in the diagnosis of cobalamin (vitamin B12) deficiency. Routine used of cobalamin standardized assays have potentially modified the frequency and the type of hematologic abnormalities. Current studies on cobalamin deficiency, including more precise definitions and the description of new etiologies of cobalamin deficiency in adults, as the food-cobalamin malabsorption syndrome, show that hematological abnormalities are generally incomplete compared to historical descriptions of megaloblastic anemia. Nevertheless, they include severe manifestations in 10% of the patients: pancytopenia, severe anemia (hemoglobin < 6 g/dl) or hemolytic anemia and pseudo thrombotic microangiopathy related to cobalamin deficiency. These studies also show the efficacy of new treatment modalities including oral cobalamin administration. Future studies will confirm these data with the routine use of the new cobalamin assay: holotranscobalamin and validate the usefulness of oral cobalamin therapy.

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Pseudo-HELLP syndrome par carence en vitamine B12: à propos de sept cas

E. Chauvet, M. Youssef, R Boukhari … (2009)

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Author and article information

Journal

Journal ID (nlm-ta): Pan Afr Med J

Journal ID (iso-abbrev): Pan Afr Med J

Journal ID (publisher-id): PAMJ

Title: The Pan African Medical Journal

Publisher: The African Field Epidemiology Network

ISSN (Electronic): 1937-8688

Publication date (Electronic): 27 May 2014

Publication date Collection: 2014

Volume: 18

Electronic Location Identifier: 99

Affiliations

[1 ]Service d'anesthésie réanimation, hôpital Taher Maamouri, Nabeul 8000, Tunisie

[2 ]Service de chirurgie générale, hôpital Taher Maamouri, Nabeul 8000, Tunisie

[3 ]Service d'imagerie médicale, hôpital Taher Maamouri, Nabeul 8000, Tunisie

Author notes

[& ]Corresponding author: Mechaal Benali, Service d'anesthésie réanimation, hôpital Taher Maamouri, Nabeul 8000, Tunisie

Article

Publisher ID: PAMJ-18-99

DOI: 10.11604/pamj.2014.18.99.2483

PMC ID: 4232030

SO-VID: 1e73c2cc-6b10-48b3-9c63-b5038404224f

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The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Pseudo-HELLP syndrome par carence en folates et/ou en vitamine B12: à propos d'un cas Translated title: Pseudo-HELLP syndrome from folate and/or vitamin B12 deficiency: about a case

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Abstract

Most cited references 6

Maternal morbidity and mortality in 442 pregnancies with hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome)

[Update of clinical findings in cobalamin deficiency: personal data and review of the literature].

Pseudo-HELLP syndrome par carence en vitamine B12: à propos de sept cas

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