Simultaneous Bilateral Serous Retinal Detachments and Cortical Visual Loss in the PRES HELLP Syndrome

Kini, Ashwini; Tabba, Subhan; Mitchell, Travis; Othman, Bayan Al; Lee, Andrew G.

doi:10.1097/wno.0000000000000942

Cited by 4 publications

(5 citation statements)

References 13 publications

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“…У одной пациентки с ПЭ и двух пациенток с HELLP-синдромом из нашего исследования отмечалось выпадение полей зрения. Имеются описания данного синдрома у пациенток с ТМА во время беременности: снижение остроты зрения у пациенток с ПЭ и с HELLP-синдромом [16], а также описание развития искажения цветового восприятия у пациентки с HELLPсиндромом, что также является симптомом задней обратимой лейкоэнцефалопатии [17]. Данная патология, в т. ч. при развитии ОНМК, также может объяснять обратимость неврологических проявлений у пациенток с ТМА [18].…”

Section: Discussionunclassified

Variants of system and organ damage in patients with various thrombotic microangiopathy subtypes in obstetric practice

et al. 2023

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Introduction. All thrombotic microangiopathy (TMA) variants in obstetric practice have a diverse clinical presentation and can manifest as various system and organ damage, which often makes it difficult or interfere with the diagnostic assessment, thus slowing down initiation of the necessary therapy.Aim. To study the clinical presentations of various TMA variants in obstetric practice.Materials and methods. A total of 313 pregnant women were enrolled in the study, of which atypical hemolytic uremic syndrome (aHUS) was diagnosed in 71 women, “HELLP syndrome” in 124 women, and “PE” with varied severity in 70 women. A group of patients with more rare causes of TMA was also identified: TTP and sepsis in 13 patients, and 35 patients without signs of TMA were included in the control group. We assessed and compared the main clinical, laboratory and instrumental findings.Results. The study identified damage to various systems and organs in various TMA types in obstetric practice. The damage to kidneys, liver, nervous system, visual organs was observed in patients with aHUS, HELLP syndrome, TTP, septic TMA and PE, while the damage to skin, cardiovascular system and lungs was detected in patients from all groups except for PE. Small and large vessel thrombotic complications were detected in patients from the former three groups. The patients with aHUS showed the maximum multisystemic presentation severity.Conclusions. The thrombotic microangiopathy in obstetrics is generalized in nature, and various symptoms of organ dysfunction require a multidisciplinary approach to such patients.

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Variants of system and organ damage in patients with various thrombotic microangiopathy subtypes in obstetric practice

et al. 2023

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“…In addition, investigating the related genes to metabolism pathways or reconstructions of gene networks (such as hub genes) in HELLP syndrome can provide new opportunities for drug targets and pharmaceutical discoveries (Table 1). 14 In this study, after evaluating the datasets, a series of important molecular pathways were identified. After KEGG pathway analysis, it was found that PI3K/AKT, JAK/STAT pathways, inflammatory pathways, and molecular pathways involved in the cellular metabolism are the most important ones in the pathogenesis of HELLP syndrome.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Bioinformatics analysis of microarray data to identify hub genes, as diagnostic biomarker of HELLP syndrome: System biology approach

Asadikalameh

Maddah

Maleknia

et al. 2022

J of Obstet and Gynaecol

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Background: HELLP syndrome is one of the disorders characterized by hemolysis, increased liver enzymes and decreased platelet count. So far, many molecular pathways and genes have been identified in relation to the pathogenesis of this syndrome; however, the main cause of the incidence and progression of the disease has not been identified. Using the biological system approach is a way to target patients by identifying genes and molecular pathways. In this study, we investigated genes and important molecular factors in the pathogenesis of HELLP syndrome. Material and Methods: In this study, the microarray dataset was downloaded from Gene Expression Omnibus (GEO) database and analyzed using the GEO2R online tool for identifying differentially expressed genes (DEGs). Enrichment analysis of DEGs was evaluated using the Enrichr database. Then, protein-protein interaction (PPI) networks were constructed via the STRING database; they were visualized by Cytoscape. Then the STRING database was used to construct PPI networks. The hub genes were recognized using the cytoHubba. Ultimately, the interaction of the miRNA-hub genes and drug-hub genes were also evaluated. Result: After analysis, it was found that some genes with the highest degree of connectivity are involved in the pathogenesis of HELLP syndrome, which are known as the hub genes. These genes are as follows: KIT, JAK2, LEP, EP300, HIST1H4L, HIST1H4F, HIST1H4H, MMP9, THBS2, and ADAMTS3. Has-miR-34a-5p was also most associated with hub genes. Conclusion: Finally, it can be said, that the identification of genes and molecular pathways in HELLP syndrome can be helpful in identifying the pathogenesis pathways of the disease, and designing therapeutic targets.

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“…Preeclampsia affects approximately 3% to 5% of pregnancies and is defined as blood pressure of 140/90 mm Hg or greater after 20 weeks of gestation with proteinuria. 4 In addition to exudative retinal detachment, preeclampsia can lead to several other ocular and visual pathway manifestations including hypertensive retinopathy, 5 retinal arteriolar spasm, 4 cotton-wool spots, 5 macular edema, 6 retinal pigment epithelial (RPE) infarction and necrosis, 7 retinal hemorrhages, 5 posterior reversible encephalopathy syndrome, 8 anterior ischemic optic neuropathy, 9 and even cortical blindness. 9 Exudative retinal detachments affect approximately 0.2% to 2.0% of patients with preeclampsia and 0.9% of patients with HELLP syndrome.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Exudative Retinal Detachments, Chemosis, and Impaired Ocular Motility in the Setting of Preeclampsia and HELLP Syndrome

Govindaraju

Schimmel

Trese

et al. 2022

Journal of VitreoRetinal Diseases

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Purpose: We present a complication of preeclampsia and hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome including bilateral exudative retinal detachments, bullous chemosis, and impaired ocular motility. Methods: The patient was followed in the inpatient and outpatient setting with clinical examinations, optical coherence tomography, widefield fundus photography, neuroimaging including magnetic resonance imaging of the brain/orbits, as well as carotid artery ultrasonography. Results: Our patient was admitted with bilateral vision changes in the setting of preeclampsia and HELLP syndrome and was found to have bilateral exudative detachments, retinal exudation, severe bullous chemosis, and impaired motility. She was started on intravenous dexamethasone followed by an extended prednisone taper with resolution of her ocular findings and return of her vision to baseline. Conclusions: There is evidence that HELLP syndrome and preeclampsia are proinflammatory syndromes. Aggressive blood pressure control, corticosteroids, and a multidisciplinary approach might accelerate visual and systemic recovery in these complex cases.

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Simultaneous Bilateral Serous Retinal Detachments and Cortical Visual Loss in the PRES HELLP Syndrome

Cited by 4 publications

References 13 publications

Variants of system and organ damage in patients with various thrombotic microangiopathy subtypes in obstetric practice

Variants of system and organ damage in patients with various thrombotic microangiopathy subtypes in obstetric practice

Bioinformatics analysis of microarray data to identify hub genes, as diagnostic biomarker of HELLP syndrome: System biology approach

Bilateral Exudative Retinal Detachments, Chemosis, and Impaired Ocular Motility in the Setting of Preeclampsia and HELLP Syndrome

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