The radiologist cries HELLP

We report a case of the haemolysis, elevated liver enzymes, low platelets (HELLP) syndrome in a primigravida, in whom ultrasound examination demonstrated large, “geographical” areas of increased echogenicity within the right lobe of the liver. Haematological investigations showed classical features of the HELLP syndrome. Both the ultrasound signs and the serological tests reverted to normal soon after the delivery of the baby. There are no other reports of hepatic parenchymal abnormality detected sonographically. Although these features are non-specific, recognition of similar ultrasound appearances should alert radiologists to the need for urgent haematological investigations. Delayed treatment may lead to the death of the mother or baby.