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A HIDDEN SIDE OF THE HELLP STORY. |
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At the end of 1967, M. Galton, a well known British investigator working in the U.S.A., was finishing his application to spend a sabbatical year doing research at the Hospital de Gineco-Obstetricia N� 2 del Centro Medico Nacional del IMSS in Mexico City. The main purpose during the following year would be to study the coagulation and fibrinolytic changes caused by toxemia of pregnancy with emphasis on several platelets functions and characteristics. The application was accepted by the proper institutional authorities with several common requirements for this type of concerted investigation. Thus, M. Galton, his wife (another researcher with interest on the thyroid function during normal and abnormal human pregnancy), and two sons, spent the year 1968 in Mexico and completed their research goals, but the final text of various possible subjects related to the impressive size and variety of data collected was to be drawn later on after returning to his U.S.A. position. Unfortunately, a highway fatal accident caused M. Galton demise near his hometown in the U.S.A. |
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Ms. Galton asked professor F.K. Beller (also a well known investigator, originally from Germany but working at the time in the U.S.A., with interests on blood coagulation and specially on disseminated intravascular coagulation) to take a look at M. Galton's collected data and see what could be done about it since it would be another painful loss to let all that valuable information go to waste. F.K. Beller accepted the task and after a trip to Mexico City to see personally the quality and reliability of the clinical and research work carried regularly at the HGO N� 2 del CMN del IMSS returned to the U.S.A. and did the best he could with M. Galton�s data. After some natural difficulties the final text was published in the J. Reprod. Med. with the title "Coagulation studies on the peripheral circulation of patients with toxemia of pregnancy. A study for the evaluation of disseminated intravascular coagulation in toxemia" ( J Reprod Med 1971;6:78-89). Although a particular syndrome was not identified in this investigation several unexpected and so far unreported data pointed in that direction and these were the first origins for future developments. |
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After M. Galton's departure from Mexico City and more so a few days later when the news of his accident were known, the various lines of investigation started by his team remained open and active resulting among various other local publications in an article dealing with such blood coagulation abnormalities in the worst stage of toxemia of pregnancy, that is in eclamptic women, published in the Am.J.Obstet.Gynecol. with the title "Abnormal coagulation and fibrinolysis in eclampsia. A clinical and laboratory correlation study" (Am.J.Obstet.Gynecol. 1976;124:681-687 by Lopez-Llera MM, Espinosa MML, Diaz de Leon PM, Rubio LG). Here, again the concept of some form of chronic intravascular coagulation was emphasized but no clear distinction of a special syndrome was stated although the implications of the findings kept on pointing towards such possibility. |
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The identification of an abnormal process present in a given percentage of cases that should be considered as a peculiar complication or evolution of pre-eclampsia-eclampsia was suggested in a paper published in Spanish with the title "Patogenia de la trombosis y la hemorragia en la toxemia grave y en la eclampsia" (Anuario de Actualizacion en Medicina N� 25 IMSS (Mexico) 1977 by Espinosa MML, Lopez-Llera MM, Diaz de Leon PM), and more definitely some years later in "Microangiopatia trombotica y hemolisis intravascular en la toxemia" by Espinosa MML, Diaz de LeonPM, Ya�ez I, Neninger JH. Colmenares MI (Rev.Med.IMSS (Mexico) 1982;20:35-41.) The concept of "microangiopathic hemolytic anemia of pre-eclampsia" was clearly stated and turned out to be the same condition as the HELLP syndrome proposed by L. Weinstein also in 1982, ( Am J Obstet Gynecol 1982; 142:149-167 ) |
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These are the facts, printed and published, some in English some in Spanish. Do you have some doubts? Go to the original articles, read them carefully and without any prejudice, specially try to retrieve those in Spanish. It would be just as easy as finding a needle in a haystack. And that is the point, a funny word or acronym in English, although incomplete and superficial, sells much better than a serious more scientific name in any other language, buried and ignored forever. Science has its favorites. Spanish is not one of them. Good luck !! |
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