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 with severe preeclampsia with and without HELLP syndrome admitted to our hospital between 1995 and 1997. Patients were grouped by diagnosis and timing of platelet nadir. Analysis of variance and regression analysis were used for data analysis. Results. Of 177 patients, 91 had HELLP syndrome, and 86 had severe preeclampsia alone. The WBC counts were significantly higher in patients with HELLP syndrome (12.5 ± .442 x 10 9 /L) than in patients with severe preeclampsia (10.3 ± .288 x 10 9 /L). Regression analysis showed that platelet counts varied inversely with WBC counts Also, patients with class I HELLP syndrome had significantly higher WBC counts than patients with other classes of HELLP syndrome. Conclusion. The finding of an association between increasing leukocytosis and worsening thrombocytopenia early in the course of HELLP syndrome supports the hypothesis that it may represent an inflammatory process.