Acute exacerbated lupus erythematosus - Differential diagnosis of a HELLP syndrome.

The term HELLP-syndrome was inaugurated by Weinstein in 1982 and is characterised by the following trias in patients with pregnancy-induced hypertonia (PIH): haemolysis, elevated liver enzymes, low platelets. In recent years cases of "incomplete" HELLP-syndrome have been reported which lack some of the symptoms. With increasing awareness of this disease among obstetricians the reported incidence is increasing. Undoubtedly some patients are misclassified as having HELLP-syndrome and consequently receive inadequate therapy. Other pregnancy-induced alterations or selected diseases in internal medicine may mimick symptoms of HELLP-syndrome. To stress the necessity for considering differential diagnoses in patients with HELLP-syndrome, we report on the following clinical observation. A 23-year old patient was referred to our hospital under diagnosis of HELLP-syndrome during her 33 + 2(nd) week of gestation. Because of a pathologic cardiotocogram and urgent C-section was performed. After birth the patient was diagnosed of having a systemic Lupus erythematosus which was aggravated during pregnancy.