Is it necessary to specify the HELLP syndrome

Abstract In 1982 Weinstein described the Hellp-Syndrome in pre-eclampsia. Two personal case histories have led the authors to discuss the need to specify this syndrome. Apart from the classical elements of pre-eclampsia, which are: arterial hypertension, proteinuria and oedema, there are bowel symptoms in 86% of cases and on the biological level there is thrombocytopenia and a rise in the transaminases as well as a haemolytic anaemia. Some cases of rupture of the liver have been described. Treatment is that of pre-eclampsia. This involves treatment with cortisone and sometimes with heparin. Delivery of the fetus is, however, the only really effective treatment. The characteristic three elements of the Hellp-Syndrome seem to be linked to disseminated intravascular coagulation and have long been considered very serious factors in pre-eclampsia. On the other hand it does seem to be useful for the clinician to know about the Hellp-syndrome in order to estimate the seriousness of a case where there are vasculo-renal elements in the syndrome and in order to avoid diagnosis mistakes in cases where the symptoms are often deceptive.