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Hepatic involvement in HELLP syndrome: an update with emphasis on imaging features

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Abstract

HELLP syndrome, which consists of hemolysis, elevated liver enzymes, and low platelet count is an unusual complication of pregnancy that is observed in only 10% to 15% of women with preeclampsia. Hepatic involvement in HELLP syndrome may present with various imaging features depending on the specific condition that includes nonspecific abnormalities such as perihepatic free fluid, hepatic steatosis, liver enlargement, and periportal halo that may precede more severe conditions such as hepatic hematoma and hepatic rupture with hemoperitoneum. Maternal clinical symptoms may be nonspecific and easily mistaken for a variety of other conditions that should be recognized. Because hepatic hematoma occurring in association with preeclampsia and HELLP syndrome is a potentially life-threatening complication, prompt depiction is critical and may help reduce morbidity and mortality. This review provides an update on demographics, risk factors, pathophysiology, and clinical features of hepatic complications due to HELLP syndrome along with a special emphasis on the imaging features of these uncommon conditions.

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Authors and Affiliations

  1. Department of Abdominal Imaging, Hôpital Lariboisière-APHP, 2, Rue Ambroise Paré, 75010, Paris, France

    Laetitia Perronne, Anthony Dohan, Youcef Guerrache, Mourad Boudiaf & Philippe Soyer

  2. Université Paris-Diderot, Sorbonne Paris Cité, 10 Avenue de Verdun, 75010, Paris, France

    Anthony Dohan & Philippe Soyer

  3. Department of Radiology, CHU d’Angers, 4 Rue Larrey, 49933, Angers Cedex 9, France

    Paul Bazeries & Christophe Aubé

  4. Department of Imaging, CHU de Caen, Avenue de la Côte-de-Nacre, 14033, Caen Cedex 9, France

    Audrey Fohlen

  5. Department of Radiology, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Claude Bernard University Lyon 1, 165 Chemin du Grand Revoyet, 69495, Pierre Bénite, France

    Pascal Rousset

  6. Department of Radiology, CHU Nancy-Brabois, Université de Lorraine, Allée du Morvan, 54511, Nancy Cedex, France

    Valérie Laurent

  7. Obstetrics and Fetal-Medicine Unit, CHU de Nancy, Université de Lorraine, 10, Rue Heydenreich, 54000, Nancy, France

    Olivier Morel

  8. Department of Radiology, Hôpital Robert Debré, 11 Boulevard Pasteur, 51092, Reims, France

    Christine Hoeffel

Authors
  1. Laetitia Perronne
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  2. Anthony Dohan
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  3. Paul Bazeries
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  4. Youcef Guerrache
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  5. Audrey Fohlen
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  6. Pascal Rousset
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  7. Christophe Aubé
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  8. Valérie Laurent
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  9. Olivier Morel
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  10. Mourad Boudiaf
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  11. Christine Hoeffel
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  12. Philippe Soyer
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Correspondence to Anthony Dohan.

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Perronne, L., Dohan, A., Bazeries, P. et al. Hepatic involvement in HELLP syndrome: an update with emphasis on imaging features. Abdom Imaging 40, 2839–2849 (2015). https://doi.org/10.1007/s00261-015-0481-1

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  • DOI: https://doi.org/10.1007/s00261-015-0481-1

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