THROMBOCYTOPENIA WITH THE HELLP-SYNDROME - REPORT OF 2 CASES WITH REVERSAL IN NORMOTENSIVE AND NONPROTEINURIC GRAVIDAS

BACKGROUND: In the absence of hypertension and liver enzymes and low p latelet count (HELLP syndrome) present a diagnostic and therapeutic pr oblem. CASES: Two atypical cases occurred of HELLP syndrome diagnosed by hemolysis, elevated liver enzymes and low platelet count. The patie nts presented early in the third trimester with epigastric pain and la cked the usual signs of preeclampsia, such as hypertension and protein uria. The patients were managed expectantly; during this time they bec ame hypertensive, but the thrombocytopenia resolved. CONCLUSION: Pregn ant women with hemolysis, elevated liver enzymes and thrombocytopenia who do not have hypertension or proteinuria should undergo complete di agnostic evaluation. If other etiologies are ruled out, the patient sh ould be managed as appropriate for severe preeclampsia complicated by the HELLP syndrome.