title: HELLP syndrome: a diagnostic conundrum with severe complications.
abstract: The HELLP (haemolysis, elevated liver enzymes, low platelets) syndrome is believed to be part of the spectrum of pre-eclampsia, which falls within the category of hypertensive disorders of pregnancy. Maternal and fetal complications are more severe in HELLP as opposed to pre-eclampsia alone. We describe a 26-year-old primigravida woman with no medical history who presents with signs of HELLP with marked transaminitis and mild disseminated intravascular coagulation at 35 weeks of gestation who required emergent delivery of the fetus; the patient also sustained acute kidney injury requiring continuous veno-venous hemodiafiltration and a prolonged intensive care unit admission. Remarkably, with supportive care, all laboratory derangements, including renal function, normalised after 4 weeks. We discuss the diagnostic conundrum when faced with the possible diagnosis of HELLP in discriminating from its many imitators in order to assume proper treatment.
authors.affiliation: Department of Medicine, Jacobi Medical Center, Bronx, New York, USA.
authors.forename: Devika
authors.initials: D
authors.lastname: Rao
authors.affiliation: Department of Medicine/Nephrology, Jacobi Medical Center, Bronx, New York, USA.
authors.forename: Nikulkumar Kumar
authors.initials: NK
authors.lastname: Chaudhari
authors.affiliation: Jacobi Medical Center, Bronx, New York, USA.
authors.forename: Robert Michael
authors.initials: RM
authors.lastname: Moore
authors.affiliation: Department of Medicine, Jacobi Medical Center, Bronx, New York, USA.
authors.forename: Belinda
authors.initials: B
authors.lastname: Jim
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D002585:Cesarean Section; D003422:Critical Care; D003937:Diagnosis, Differential; D005260:Female; D017359:HELLP Syndrome / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000379:methods; D011296:Prenatal Diagnosis / Q000379:methods; D016896:Treatment Outcome; D014218:Triage / Q000379:methods