HELLP syndrome - A rare, early presentation at 17 weeks of gestation

BACKGROUND: The occurrence of hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome before 20 weeks of gestation is extremely rare. This condition has been reported in only few cases, and always in conjunction with other comorbidities such as fetal triploidy and the antiphospholipid syndrome. CASE: A 24-year-old woman was admitted at 15 weeks and 3 days of gestation with uncontrollable hypertension and proteinuria. An extensive workup did not reveal any underlying medical or obstetric conditions. Within 11 days of admission her condition deteriorated and thediagnosis of severe HELLP syndrome was supported by the findings of hemolysis, elevated liver enzymes, and severe thrombocytopenia, all of which resolved after termination of the pregnancy. CONCLUSION: Clinicians should consider the diagnosis of HELLP syndrome in women presenting with clinical manifestations or laboratory abnormalities consistent with this diagnosis, even before 20 weeks of gestation.