Eculizumab for the treatment of preeclampsia/HELLP syndrome

Placenta. 2013 Feb;34(2):201-3. doi: 10.1016/j.placenta.2012.11.014. Epub 2012 Dec 8.


Severe preeclampsia with hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome is a leading cause of maternal and neonatal morbidity and mortality worldwide. Occurrence at an extremely premature gestational age is most challenging as there are dichotomous imperatives: delivery as definitive therapy for maternal health vs. prolongation of pregnancy to avoid prematurity and associated morbidities. We describe a patient presenting with severe preeclampsia/HELLP syndrome at 26 weeks gestation that was treated with Eculizumab, a targeted inhibitor of complement protein C5, which resulted in marked clinical improvement and complete normalization of lab parameters. Pregnancy was prolonged 17 days, likely resulting in a reduction of neonatal morbidity with its associated short and long-term health care costs. Successful use of Eculizumab in this case suggests that complement inhibition may be an effective treatment strategy for severe preeclampsia/HELLP syndrome.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Complement C5 / antagonists & inhibitors
  • Complement Inactivating Agents / therapeutic use*
  • Female
  • Gestational Age
  • HELLP Syndrome / immunology
  • HELLP Syndrome / therapy*
  • Humans
  • Infant, Newborn
  • Infant, Very Low Birth Weight
  • Male
  • Pre-Eclampsia / immunology
  • Pre-Eclampsia / therapy*
  • Pregnancy


  • Antibodies, Monoclonal, Humanized
  • Complement C5
  • Complement Inactivating Agents
  • eculizumab