Plasmapheresis in Acute Fatty Liver of Pregnancy: An Effective Treatment

Majidi, Mohammad Reza; Vafaeimanesh, Jamshid

doi:10.1155/2013/615975

Cited by 16 publications

(15 citation statements)

References 5 publications

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“…Intensive therapeutic support is necessary for both maternal and fetal survival and plasmapheresis and liver transplantation should be considered in some severe cases [46] . Although AFLP does not have a tendency to recur in subsequent pregnancies in most cases [42] , since the recurrence rate is higher in cases with genetic mutation in LCHAD, close follow up is necessary for the groups.…”

Section: Managementmentioning

confidence: 99%

Advances in understanding and treating liver diseases during pregnancy: A review

Kamimura

Abé

Kawai

et al. 2015

WJG

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Liver disease in pregnancy is rare but pregnancy-related liver diseases may cause threat to fetal and maternal survival. It includes pre-eclampsia; eclampsia; haemolysis, elevated liver enzymes, and low platelets syndrome; acute fatty liver of pregnancy; hyperemesis gravidarum; and intrahepatic cholestasis of pregnancy. Recent basic researches have shown the various etiologies involved in this disease entity. With these advances, rapid diagnosis is essential for severe cases since the decision of immediate delivery is important for maternal and fetal survival. The other therapeutic options have also been shown in recent reports based on the clinical trials and cooperation and information sharing between hepatologist and gynecologist is important for timely therapeutic intervention. Therefore, correct understandings of diseases and differential diagnosis from the pre-existing and co-incidental liver diseases during the pregnancy will help to achieve better prognosis. Therefore, here we review and summarized recent advances in understanding the etiologies, clinical courses and management of liver disease in pregnancy. This information will contribute to physicians for diagnosis of disease and optimum management of patients.

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Section: Managementmentioning

confidence: 99%

Advances in understanding and treating liver diseases during pregnancy: A review

Kamimura

Abé

Kawai

et al. 2015

WJG

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“…Another case report has suggested that PE may be a successful treatment for pregnant women with antiphospholipid syndrome [108] . PE was also successfully used in pregnant patients with acute fatty liver of pregnancy [109,110] . Additionally two cases of hypertriglyceridemiainduced acute pancreatitis during pregnancy and a case of a pregnant woman with Pemphigus vulgaris were successfully treated by PE [111,112] .…”

Section: Plasmapheresis/ Apheresismentioning

confidence: 99%

Preeclampsia from a renal point of view: Insides into disease models, biomarkers and therapy

Müller-Deile

Schiffer

2014

WJN

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Proteinuria is a frequently detected symptom, found in 20% of pregnancies. A common reason for proteinuria in pregnancy is preeclampsia. To diagnose preeclampsia clinically and to get new insights into the pathophysiology of the disease it is at first essential to be familiar with conditions in normal pregnancy. Animal models and biomarkers can help to learn more about disease conditions and to find new treatment strategies. In this article we review the changes in kidney function during normal pregnancy and the differential diagnosis of proteinuria in pregnancy. We summarize different pathophysiological theories of preeclampsia with a special focus on the renal facets of the disease. We describe the current animal models and give a broad overview of different biomarkers that were reported to predict preeclampsia or have a prognostic value in preeclampsia cases. We end with a summary of treatment options for preeclampsia related symptoms including the use of plasmapheresis as a rescue therapy for so far refractory preeclampsia. Most of these novel biomarkers for preeclampsia are not yet implemented in clinical use. Therefore, we recommend using proteinuria (measured by UPC ratio) as a screening parameter for preeclampsia. Delivery is the only curative treatment for preeclampsia. In early preeclampsia the primary therapy goal is to prolong pregnancy until a state were the child has an acceptable chance of survival after delivery.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Preeclampsia; Pregnancy; Proteinuria; Biomarkers; Treatment Core tip: This review summarises different pathophysiological theories of preeclampsia with a special focus on the renal facets of the disease. In this context current animal models are presented. The reader gets a broad overview about different biomarkers for preeclampsia. Furthermore, the article discusses treatment options for preeclampsia related symptoms including the use of plasmapheresis as a rescue therapy for so far refractory preeclampsia.Müller-Deile J, Schiffer M. Preeclampsia from a renal point of view: Insides into disease models, biomarkers and therapy. World

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“…In view of the underlying biochemical metabolic disorders with the accumulation of large amounts of toxic substances, some blood purification technologies have been applied to AFLP [2,3]. Plasma exchange (PE) has been used with success in a few severe cases of AFLP [4,5]. However, PE therapy requires large quantities of plasma and can lead to allergic reactions and severe anaphylactic shock.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Combining Plasma Exchange with Plasma Perfusion in Acute Fatty Liver of Pregnancy: A Retrospective Analysis

Ding

Liang²,

Lou

et al. 2015

Gynecol Obstet Invest

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Background/Aims: Acute fatty liver of pregnancy (AFLP) is a severe liver failure condition that has limited therapeutic approaches. We aimed to evaluate the efficacy of combining plasma exchange (PE) and plasma perfusion (PP) with conventional therapy for the treatment of AFLP using a retrospective analysis. Methods: Among 22 patients with AFLP, 16 cases were treated with conventional treatment (CT group), while the other 6 cases were treated with PE and PP in addition to conventional therapy (CT+PE+PP group). Treatment efficacy was based primarily on survival and secondarily on liver and kidney functions 2 weeks after treatment. Adverse effects were also assessed at the same time point. Results: In the CT+PE+PP group, 5 (83.3%) patients improved, while 1 (16.7%) patient died of multiple organ dysfunction syndrome. In the CT group, 3 (18.75%) patients improved, while 13 (81.2%) patients died of complications. Liver and kidney functions and survival were significantly improved in the CT+PE+PP group (p < 0.05) compared to the CT group. Conclusions: Timely application of PE and PP in the early phase of AFLP may be a promising treatment to halt or reverse the progression of AFLP.

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Plasmapheresis in Acute Fatty Liver of Pregnancy: An Effective Treatment

Cited by 16 publications

References 5 publications

Advances in understanding and treating liver diseases during pregnancy: A review

Advances in understanding and treating liver diseases during pregnancy: A review

Preeclampsia from a renal point of view: Insides into disease models, biomarkers and therapy

Effectiveness of Combining Plasma Exchange with Plasma Perfusion in Acute Fatty Liver of Pregnancy: A Retrospective Analysis

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