Abstract | INTRODUCTION: Administration of dexamethasone to the hemolysis, elevated liver enzymes, and low platelet count ( HELLP) syndrome patients (10 mg intravenously [IV] every 12 hours) shortens the disease course and reduces maternal morbidity in patients treated at the University of Mississippi Medical Center (UMMC), associated with this severe form of preeclampsia. However, the pathophysiological mechanisms involved with this intervention remain unclear. OBJECTIVE: We sought to investigate the potential role of IV dexamethasone to restore the imbalance among antiangiogenic and inflammatory factors known to be significantly elevated in women with HELLP syndrome. STUDY DESIGN: This was a single-center prospective study of women diagnosed with HELLP syndrome who were treated for IV dexamethasone at UMMC. Blood was drawn prior to dexamethasone administration and again 12 and 24 hours after the initial dexamethasone administration. Enzyme-linked immune assays were used to measure circulating inflammatory cytokines and antiangiogenic factors. A repeated-measures analysis of variance was used to analyze the data collected before, after, and during dexamethasone administration. RESULTS: CONCLUSION: We conclude that 1 important mechanism of dexamethasone administration is to blunt the release of both antiangiogenic and inflammatory factors suggested to play role in the pathophysiology of HELLP syndrome.
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Authors | Kedra Wallace, James N Martin Jr, Kiran Tam Tam, Gerd Wallukat, Ralf Dechend, Babbette Lamarca, Michelle Y Owens |
Journal | American journal of obstetrics and gynecology
(Am J Obstet Gynecol)
Vol. 208
Issue 5
Pg. 380.e1-8
(May 2013)
ISSN: 1097-6868 [Electronic] United States |
PMID | 23380266
(Publication Type: Clinical Trial, Journal Article)
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Copyright | Copyright © 2013 Mosby, Inc. All rights reserved. |
Chemical References |
- Angiogenesis Inhibitors
- Biomarkers
- Glucocorticoids
- Interleukin-6
- Tumor Necrosis Factor-alpha
- Dexamethasone
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Topics |
- Adolescent
- Adult
- Analysis of Variance
- Angiogenesis Inhibitors
(blood)
- Biomarkers
(blood)
- Blood Platelets
(drug effects)
- Dexamethasone
(pharmacology, therapeutic use)
- Drug Administration Schedule
- Enzyme-Linked Immunosorbent Assay
- Female
- Glucocorticoids
(pharmacology, therapeutic use)
- HELLP Syndrome
(blood, drug therapy)
- Hemolysis
(drug effects)
- Humans
- Injections, Intravenous
- Interleukin-6
(blood)
- Liver
(drug effects, enzymology)
- Pregnancy
- Prospective Studies
- Treatment Outcome
- Tumor Necrosis Factor-alpha
(blood)
- Young Adult
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