Eculizumab for the treatment of preeclampsia/HELLP syndrome

Abstract Severe preeclampsia with hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome is a leading cause of maternal and neonatal morbidity and mortality worldwide. Occurrence at an extremely premature gestational age is most challenging as there are dichotomous imperatives: deliver...

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Bibliographic Details
Published in:Placenta (Eastbourne) 2013-02, Vol.34 (2), p.201-203
Main Authors: Burwick, R.M, Feinberg, B.B
Format: Article
Language:English
Subjects:
Adult
Antibodies, Monoclonal, Humanized - therapeutic use
Biological and medical sciences
Complement
Complement C5 - antagonists & inhibitors
Complement Inactivating Agents - therapeutic use
Eculizumab
Embryology: invertebrates and vertebrates. Teratology
Female
Fundamental and applied biological sciences. Psychology
Gestational Age
HELLP syndrome
HELLP Syndrome - immunology
HELLP Syndrome - therapy
Humans
Infant, Newborn
Infant, Very Low Birth Weight
Internal Medicine
Male
Obstetrics and Gynecology
Pre-Eclampsia - immunology
Pre-Eclampsia - therapy
Preeclampsia
Pregnancy
Pregnancy. Parturition. Lactation
Vertebrates: reproduction
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Summary:Abstract Severe preeclampsia with hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome is a leading cause of maternal and neonatal morbidity and mortality worldwide. Occurrence at an extremely premature gestational age is most challenging as there are dichotomous imperatives: delivery as definitive therapy for maternal health vs. prolongation of pregnancy to avoid prematurity and associated morbidities. We describe a patient presenting with severe preeclampsia/HELLP syndrome at 26 weeks gestation that was treated with Eculizumab, a targeted inhibitor of complement protein C5, which resulted in marked clinical improvement and complete normalization of lab parameters. Pregnancy was prolonged 17 days, likely resulting in a reduction of neonatal morbidity with its associated short and long-term health care costs. Successful use of Eculizumab in this case suggests that complement inhibition may be an effective treatment strategy for severe preeclampsia/HELLP syndrome.
ISSN:0143-4004
1532-3102
DOI:10.1016/j.placenta.2012.11.014