Therapeutic plasma exchange in postpartum HELLP syndrome: a case report

Nana Kojima, Kosuke Kuroda, Makiko Tani, Tomoyuki Kanazawa, Kazuyoshi Shimizu, Jota Maki, Hisashi Masuyama, Hiroshi Morimatsu

Research output: Contribution to journalArticlepeer-review


Background: Postpartum hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome is more difficult to treat than HELLP syndrome during pregnancy. We describe a case of postpartum HELLP syndrome that responded to plasma exchange (PE) therapy. Case presentation: A 30-year-old primipara woman was hospitalized for gestational hypertension at 33 weeks of gestation and underwent an emergent cesarean section at 36 weeks and 6 days of gestation due to rapidly progressing pulmonary edema. After delivery, liver dysfunction and a rapid decrease in platelet count were observed, and the patient was diagnosed with severe HELLP syndrome. She experienced multiple organ failure despite intensive care, and PE therapy was initiated. Her general condition dramatically stabilized within a few hours of PE therapy. Conclusion: It is controversial whether PE therapy should be used primarily in the management of HELLP syndrome, but early initiation of PE therapy could be effective for severe HELLP syndrome.

Original languageEnglish
Article number9
JournalJA Clinical Reports
Issue number1
Publication statusPublished - Dec 2023


  • HELLP syndrome
  • Plasma exchange therapy
  • Postpartum
  • Thrombotic microangiopathy

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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