{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:20:39Z","timestamp":1760188839920},"reference-count":16,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2006,11,14]],"date-time":"2006-11-14T00:00:00Z","timestamp":1163462400000},"content-version":"vor","delay-in-days":4700,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[1994,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We report our apheresis department's experience with four patients with HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome. The average age of the patients was 23.25 years (range 19\u201027). Three were in their second pregnancy while one was a primigravida. All had symptoms of pre\u2010eclampsia prior to delivery. All experienced the syndrome postpartum. Plasma exchange was instituted an average of 3.25 days postpartum (range 1.08\u20107.33 days). All underwent plasmapheresis with fresh frozen plasma replacement. The average number of plasma exchange treatments was four (range 1\u20108). The first laboratory parameter to reach its peak\/nadir was the aspartate aminotransferase (AST), followed by the lactate dehydrogenase (LDH) enzyme level, followed by the hemoglobin (HGB) level, and, finally, the platelet count (PLT). The AST was the first parameter to peak and the first to normalize. In the three cases in which more than one plasmapheresis procedure was performed, plasmapheresis was required for an average of 98 hours (range 39\u2010206 hours) after a normal AST level was obtained in order to achieve a self\u2010sustaining platelet count of = 100 \u00d7 109\/L. No additional exchanges were required to maintain the PLT once a PLT of over 100 \u00d7 109\/ L was attained. The laboratory values normalized in the following order: AST, HGB, PLT, and LDH. Three patients were discharged anemic. One was discharged with a normal LDH level. By our experience, awaiting normal LDH levels as an indicator for cessation of plasma exchange therapy would mean subjecting the patients to many unnecessary procedures. Although AST elevation reflects the peak of disease activity, a platelet count of over 100 \u00d7 109\/L is more reflective of adequate reversal of the disease process.<\/jats:p>","DOI":"10.1002\/jca.2920090406","type":"journal-article","created":{"date-parts":[[2007,2,21]],"date-time":"2007-02-21T16:03:31Z","timestamp":1172073811000},"page":"228-235","source":"Crossref","is-referenced-by-count":17,"title":["HELLP syndrome: Laboratory parameters and clinical course in four patients treated with plasma exchange"],"prefix":"10.1002","volume":"9","author":[{"given":"C. J.","family":"Julius","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Z. L.","family":"Dunn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. F.","family":"Blazina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,11,14]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(91)91429-Z"},{"key":"e_1_2_1_3_2","first-page":"136","article-title":"Possible role for exchange plasmapheresis with fresh frozen plasma for maternal indications in selected cases of preeclampsia and eclampsia","volume":"67","author":"Schwartz ML","year":"1986","journal-title":"Obstet Gynecol"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/jca.2920070102"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/jca.2920010204"},{"key":"e_1_2_1_6_2","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/0140-6736(92)90638-J","article-title":"Epoprostenol infusions in thrombotic microangiopathy of pregnancy (Letter)","volume":"339","author":"DeBelder AJ","journal-title":"Lancet"},{"key":"e_1_2_1_7_2","first-page":"119","article-title":"Thrombotic microangiopathy in pregnancy and the postpartum period","volume":"24","author":"Weiner CP","year":"1987","journal-title":"Semin Hematol"},{"key":"e_1_2_1_8_2","first-page":"13","article-title":"HELLP syndrome and its complications","volume":"36","author":"Cantanzarite V","year":"1991","journal-title":"Contemporary OB\/GYN"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(90)90835-U"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-199011000-00001"},{"issue":"1","key":"e_1_2_1_11_2","first-page":"508A","article-title":"Thrombotic thrombocytopenic purpura (TTP) medical research group (Abstract)","volume":"76","author":"Gutterman L","year":"1990","journal-title":"Blood"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(85)80223-4"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI111242"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(12)80752-9"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1992.32893032096.x"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199203053261015"},{"key":"e_1_2_1_17_2","first-page":"63a","article-title":"Protein A immunoad\u2010sorption (PAI) in classical thrombotic thrombocytopenic purpura (TTP) refractory to plasma exchange: report of eleven patients (abstract)","volume":"80","author":"Gaddis T","year":"1992","journal-title":"Blood"}],"container-title":["Journal of Clinical Apheresis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjca.2920090406","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.2920090406","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,24]],"date-time":"2023-10-24T10:01:12Z","timestamp":1698141672000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jca.2920090406"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1994,1]]},"references-count":16,"journal-issue":{"issue":"4","published-print":{"date-parts":[[1994,1]]}},"alternative-id":["10.1002\/jca.2920090406"],"URL":"https:\/\/doi.org\/10.1002\/jca.2920090406","archive":["Portico"],"relation":{},"ISSN":["0733-2459","1098-1101"],"issn-type":[{"value":"0733-2459","type":"print"},{"value":"1098-1101","type":"electronic"}],"subject":[],"published":{"date-parts":[[1994,1]]}}}