Response to Plasmapheresis Measured by Angiogenic Factors in a Woman with Antiphospholipid Syndrome in Pregnancy

Abstract EN

An imbalance of angiogenic and antiangiogenic placental factors such as endoglin and soluble fms-like tyrosine kinase 1 has been implicated in the pathophysiology of preeclampsia.

Extraction of these substances by plasmapheresis might be a therapeutical approach in cases of severe early-onset preeclampsia.

Case Report.

A 21-year-old primigravida with antiphospholipid syndrome developed early-onset preeclampsia at 18 weeks’ gestation.

She was treated successfully with plasmapheresis in order to prolong pregnancy.

Endoglin and sflt-1-levels were measured by ELISA before and after treatment.

Endoglin levels decreased significantly after treatment (p < 0.05) and showed a significant decrease throughout pregnancy.

A rerise of endoglin and sflt-1 preceded placental abruption 4 weeks before onset of incident.

Conclusion.

Due to the limited long-term therapeutical possibilities for pregnancies complicated by PE, plasmapheresis seems to be a therapeutical option.

This consideration refers especially to pregnancies with early-onset preeclampsia, in which, after first conventional treatment of PE, prolongation of pregnancy should be above all.