Published online Feb 26, 2021. doi: 10.12998/wjcc.v9.i6.1259
Peer-review started: September 8, 2020
First decision: December 8, 2020
Revised: December 16, 2020
Accepted: January 5, 2021
Article in press: January 5, 2021
Published online: February 26, 2021
Hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome is a severe complication in the third trimester of pregnancy. It often co-exists and shares some similar pathophysiological changes with preeclampsia (PE), however, the inflammatory reaction of HELLP is stronger. Since HELLP syndrome is life-threatening to both the gravida and the fetus, there is an urgent need for available predictive and prognostic indicators of HELLP.
Recently, new available systemic inflammatory response (SIR) markers from complete blood cell count (CBC), such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), platelet distribution width (PDW) and red cell distribution width (RDW), have been widely implemented in the diagnosis of patients with inflammatory diseases. These indicators have been widely investigated in PE but less analyzed in HELLP syndrome.
To analyze SIR markers in HELLP syndrome patients.
A case-control study enrolled 630 cases (210 patients with HELLP syndrome, 210 patients with merely PE, and 210 healthy gravidae [control group]) was conducted. SIR markers such as NLR, RDW, MPV, PDW and PLR were compared among three groups.
The NLR, MPV, PDW, leukocyte and neutrophil count were highest in the HELLP group, lower in the PE group, and lowest in the control group. The HELLP group had a lower lymphocyte count than both the PE and control groups. The platelet counts and the PLR in the HELLP group were lower than those in the two other groups. RDW values in the HELLP group were higher than both the PE and control groups.
SIR markers such as NLR, RDW, MPV and PDW were increased in patients with HELLP syndrome, meanwhile the PLR was decreased in these patients.
Being easily available, these SIR markers from CBC may become predictive and prognostic indicators and even useful additions to the current diagnostic standard of HELLP syndrome if they are confirmed by further more studies.