Leukocytosis is proportional to HELLP syndrome severity: Evidence for an inflammatory form of preeclampsia

Background. We investigated the possibility that HELLP syndrome is in part a systemic inflammatory response. Methods. We evaluated total white blood cell (WBC) counts of all patients w ith severe preeclampsia with and without HELLP syndrome admitted to our hos pital between 1995 and 1997. Patients were grouped by diagnosis and timing of platelet nadir: Analysis of variance and regression analysis were used f or data analysis. Results, Of 177 patients, 91 had HELLP syndrome, and 86 had severe preeclam psia alone, The WBC counts were significantly higher in patients with HELLP syndrome (12.5 +/- .442 x 10(9)/L) than in patients with severe preeclamps ia (10.3 +/- .288 x 10(9)/L). Regression analysis showed that platelet coun ts varied inversely with WBC counts. Also, patients with class I HELLP synd rome had significantly higher WBC counts than patients with other classes o f HELLP syndrome. Conclusion. The finding of an association between increasing leukocytosis a nd worsening thrombocytopenia early in the course of HELLP syndrome support s the hypothesis that it may represent an inflammatory process.