HEELLP Syndrome

Question 1

Pathophysiology of HELLP syndrome

Answer 1

المفتاح
Hemolysis
ELevated Liver enzymes
Low Platelet count
Pathophysiology:

1. Endothelial Dysfunction and Vasospasm: المفتاح
   decreased blood supply of placenta Leads to systemic endothelial damage and vasoconstriction, reducing blood flow to organs (especially the liver and kidneys).
2. Hemolysis (H):
   Microangiopathic hemolytic anemia occurs due to damaged endothelium causing narrowing of blood vessels.
   Red blood cells are fragmented as they pass through small, damaged vessels (schistocytes seen on peripheral smear).
   Elevated lactate dehydrogenase (LDH) and indirect bilirubin reflect hemolysis.
3. Elevated Liver Enzymes (EL):

Hepatic blood flow obstruction and sinusoidal fibrin deposition lead to hepatocellular injury.
This causes increased liver enzymes (AST, ALT) and may result in subcapsular hematomas or liver rupture in severe cases.

4. Low Platelets (LP):
   Platelets are consumed in forming microthrombi in damaged vessels (thrombotic microangiopathy).
   This consumption leads to thrombocytopenia, increasing bleeding risk.