Acute fatty liver and HELLP syndrome: two distinct pregnancy disorders.
OBJECTIVE
to report the experience clinical, biochemical findings, complications and the maternal-perinatal outcome in patients with HELLP syndrome and acute fatty liver of pregnancy (AFLP) during the same period.


METHODS
during the period between January 1996 and December 1999, medical records of patients with the discharge diagnosis of AFLP and HELLP syndrome were reviewed for presenting symptoms, laboratory findings, maternal and perinatal complications. Routine laboratory evaluation included serial measurement of liver function tests, complete blood cell count, coagulation profile and renal function tests.


RESULTS
during the study period 10 patients had AFLP and 75 women had HELLP syndrome as the discharge diagnosis. Patients with HELLP syndrome had major parity than AFLP (P<0.006). The most common presenting symptom for patients with AFLP was malaise noted in all patients, nausea and/or vomiting, abdominal pain and jaundice were very common. Headache, abdominal or epigastric pain and hematuria were the most common symptoms of patients with HELLP syndrome. Women with AFLP had major hypoglycemia, hypocholesterolemia, hypotriglyceridemia, serum transaminase activity and low antithrombin III. Disseminated intravascular coagulation, acute renal insufficiency, ascites, seroma and encephalophaty were more common with AFLP.


CONCLUSIONS
our opinion is that AFLP had clinical presentation, biochemical findings and complications clearly distinguished of HELLP syndrome.
Vigil-De Gracia
P
P
Obstetric Intensive Care, Complejo Hospitalario de la Caja de Seguro Social, Panama, Panama. pvigil-d@cwp.net.pa
D015746:Abdominal Pain / Q000209:etiology; D000208:Acute Disease; D058186:Acute Kidney Injury / Q000209:etiology; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D020152:Antithrombin III Deficiency; D001201:Ascites / Q000209:etiology; D001219:Aspartate Aminotransferases / Q000097:blood; D002784:Cholesterol / Q000172:deficiency; D003937:Diagnosis, Differential; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D005234:Fatty Liver / Q000150:complications* / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D017359:HELLP Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000378:metabolism; D006261:Headache / Q000209:etiology; D006417:Hematuria / Q000209:etiology; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology; D007565:Jaundice / Q000209:etiology; D009325:Nausea / Q000209:etiology; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000378:metabolism; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D014280:Triglycerides / Q000172:deficiency; D014839:Vomiting / Q000209:etiology
D014280:Triglycerides; D002784:Cholesterol; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase