title: Increased serum levels of hyaluronic acid in pregnancies complicated by preeclampsia or hemolysis, elevated liver enzymes, and low platelets syndrome.
abstract: OBJECTIVE
  Fifteen percent of patients who later have hemolysis, elevated liver enzymes, and low platelets syndrome develop initially have nonspecific symptoms. Early diagnosis could ensure adequate obstetric management; however, prognostic biochemical tests are lacking. We hypothesized that elevated hyaluronic acid serum levels might be an early indicator of hemolysis, elevated liver enzymes, and low platelets syndrome because it is known to be a sensitive marker of liver cell function.
  
  
  METHODS
  Hyaluronic acid in serum was measured in patients with normal pregnancies (n = 109) and in those patients with pregnancies complicated by preeclampsia (n = 14) or hemolysis, elevated liver enzymes, and low platelets syndrome (n = 11).
  
  
  RESULTS
  A significant increase in hyaluronic acid serum concentrations was observed in patients with hemolysis, elevated liver enzymes, and low platelets syndrome or with preeclampsia (p < 0.05). The extent of hyaluronic acid serum levels in hemolysis, elevated liver enzymes, and low platelets syndrome correlated with the clinical severity of the individual course of disease as measured by intensive care unit time (r = 0.72; p < 0.02).
  
  
  CONCLUSIONS
  Serum levels of hyaluronic acid in preeclampsia and hemolysis, elevated liver enzymes, and low platelets syndrome are significantly elevated and might play an important diagnostic and prognostic role in patients with hemolysis, elevated liver enzymes, and low platelets syndrome.
authors.affiliation: Department of Obstetrics and Gynecology, University of Goettingen, Germany.
authors.forename: R G
authors.initials: RG
authors.lastname: Osmers
authors.forename: E
authors.initials: E
authors.lastname: Schütz
authors.forename: F
authors.initials: F
authors.lastname: Diedrich
authors.forename: B
authors.initials: B
authors.lastname: Wehry
authors.forename: T
authors.initials: T
authors.lastname: Krauss
authors.forename: M
authors.initials: M
authors.lastname: Oellerich
authors.forename: W
authors.initials: W
authors.lastname: Kuhn
mesh_terms: D000328:Adult; D003422:Critical Care; D005260:Female; D005865:Gestational Age; D017359:HELLP Syndrome / Q000097:blood*; D006242:Haptoglobins / Q000378:metabolism; D006461:Hemolysis; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood*; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008099:Liver / Q000201:enzymology; D010976:Platelet Count; D011225:Pre-Eclampsia / Q000097:blood* / Q000201:enzymology; D011247:Pregnancy
chemical_list: D006242:Haptoglobins; D006820:Hyaluronic Acid; D007770:L-Lactate Dehydrogenase